Abstract
Purpose
To provide an analysis of structural optical coherence tomography (OCT) and enface infrared reflectance (IR) differences between non-exudative macular neovascularizations (NE MNVs) secondary to age-related macular degeneration (AMD) and NE MNVs secondary to pachychoroid spectrum.
Methods
Patients diagnosed with NE-MNV documented by OCTA and dye angiography in the context of either AMD or pachychoroid spectrum were retrospectively included in AMD group and PACHY group respectively. Only treatment-naïve NE MNVs showing persistence of non-exudative status for at least 1 year after diagnosis were considered. Availability of good quality structural OCT B scan and IR enface acquisitions both at baseline and at 1 year follow up was also required.
Results
The study population included 15 eyes of 15 patients in AMD group and 13 eyes of 13 patients in PACHY group. AMD group showed at baseline a significantly wider pigment epithelium detachment (PED) apex angle (p = 0.02), higher homogeneity of the PED (p = 0.015), higher PED shadowing(p = 0.03). Both groups experienced a widening of apex angle (flattening of the PED) during follow-up. Ten (76.9%) patients in PACHY group showed a hyporeflective halo at the margins of the PED at baseline compared to 3/15 (20.0%) patients in AMD group (0.007), with no significant changes at 1 year follow up (p = 0.47).
Conclusion
NE-MNVs in pachychoroid eyes are characterized by sharper and more inhomogeneous PEDs with a lighter choroidal shadowing compared to NE-MNVs in AMD eyes. Moreover, they often show a hyporeflective halo around the lesion with IR imaging.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
Data availability
Data are available upon reasonable request to the corresponding author.
References
Laiginhas R, Yang J, Rosenfeld PJ, Falcão M. Nonexudative macular neovascularization—a systematic review of prevalence, natural history, and recent insights from OCT angiography. Ophthalmol Retin. 2020;4:651–61.
Querques G, Srour M, Massamba N, Georges A, Ben Moussa N, Rafaeli O, et al. Functional characterization and multimodal imaging of treatment-naïve “quiescent” choroidal neovascularization. Investig Ophthalmol Vis Sci. 2013;54:6886–92.
Sacconi R, Sarraf D, Garrity S, Freund KB, Yannuzzi LA, Gal-Or O, et al. Nascent type 3 neovascularization in age-related macular degeneration. Ophthalmol Retin. 2018;2:1097–106.
Rabiolo A, Carnevali A, Bandello F, Querques G. Optical coherence tomography angiography: evolution or revolution? Expert Rev Ophthalmol. 2016;11:243–5.
Carnevali A, Cicinelli MV, Capuano V, Corvi F, Mazzaferro A, Querques L, et al. Optical coherence tomography angiography: a useful tool for diagnosis of treatment-naïve quiescent choroidal neovascularization. Am J Ophthalmol. 2016;169:189–98.
Carnevali A, Sacconi R, Querques L, Marchese A, Capuano V, Rabiolo A, et al. Natural history of treatment-naïve quiescent choroidal neovascularization in age-related macular degeneration using OCT angiography. Ophthalmol Retin. 2018;2:922–30.
Dansingani KK, Balaratnasingam C, Klufas MA, Sarraf D, Freund KB. Optical coherence tomography angiography of shallow irregular pigment epithelial detachments in pachychoroid spectrum disease. Am J Ophthalmol. 2015;160:1243–1254.e2.
Spaide RF. The ambiguity of pachychoroid. Retina. 2021;41:231.
Shinojima A, Lee D, Tsubota K, Negishi K, Kurihara T. Retinal diseases regulated by hypoxia—basic and clinical perspectives: a comprehensive review. J Clin Med. 2021;10:5496.
Sacconi R, Fragiotta S, Sarraf D, Sadda SR, Freund KB, Parravano M, et al. Towards a better understanding of non-exudative choroidal and macular neovascularization. Prog Retinal Eye Res. 2022;92:101113.
Carnevali A, Capuano V, Sacconi R, Querques L, Marchese A, Rabiolo A, et al. OCT angiography of treatment-naïve quiescent choroidal neovascularization in pachychoroid neovasculopathy. Ophthalmol Retin. 2017;1:328–32.
Sakurada Y, Fragiotta S, Leong BCS, Parikh R, Hussnain SA, Freund KB. Relationship between choroidal vascular hyperpermeability, choriocapillaris flow density, and choroidal thickness in eyes with pachychoroid pigment epitheliopathy. Retina. 2020;40:657.
Moult EM, Alibhai AY, Rebhun C, Lee B, Ploner S, Schottenhamml J, et al. Spatial distribution of choriocapillaris impairment in eyes with choroidal neovascularization secondary to age-related macular degeneration: a quantitative OCT angiography study. Retina. 2020;40:428–45.
Matsumoto H, Hoshino J, Mukai R, Nakamura K, Kishi S, Akiyama H. Chronic choriocapillaris ischemia in dilated vortex vein region in pachychoroid neovasculopathy. Sci Rep. 2021;11:16274.
Sacconi R, Tomasso L, Corbelli E, Carnevali A, Querques L, Casati S, et al. Early response to the treatment of choroidal neovascularization complicating central serous chorioretinopathy: a OCT-angiography study. Eye. 2019;33:1809–17.
Kokame GT, Liu K, Kokame KA, Kaneko KN, Omizo JN. Clinical characteristics of polypoidal choroidal vasculopathy and anti-vascular endothelial growth factor treatment response in caucasians. Ophthalmologica. 2019;243:178–86.
Romdhane K, Zola M, Matet A, Daruich A, Elalouf M, Behar-Cohen F, et al. Predictors of treatment response to intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy for choroidal neovascularisation secondary to chronic central serous chorioretinopathy. Br J Ophthalmol. 2020;104:910–6.
Hara C, Wakabayashi T, Sayanagi K, Nishida K. Refractory age-related macular degeneration due to concurrent central serous chorioretinopathy in previously well-controlled eyes. Pharmaceuticals. 2023;16:89.
Narita C, Wu Z, Rosenfeld PJ, Yang J, Lyu C, Caruso E, et al. Structural OCT signs suggestive of subclinical nonexudative macular neovascularization in eyes with Large Drusen. Ophthalmology. 2020;127:637–47.
Shi Y, Motulsky EH, Goldhardt R, Zohar Y, Thulliez M, Feuer W, et al. Predictive value of the OCT double-layer sign for identifying subclinical neovascularization in age-related macular degeneration. Ophthalmol Retin. 2019;3:211–9.
Forte R, Coscas F, Serra R, Cabral D, Colantuono D, Souied EH. Long-term follow-up of quiescent choroidal neovascularisation associated with age-related macular degeneration or pachychoroid disease. Br J Ophthalmol. 2020;104:1057–63.
Cheung CMG, Lai TYY, Teo K, Ruamviboonsuk P, Chen SJ, Kim JE, et al. Polypoidal choroidal vasculopathy: consensus nomenclature and non-indocyanine green angiograph diagnostic criteria from the Asia-Pacific Ocular Imaging Society PCV workgroup. Ophthalmology. 2021;128:443–52.
Author information
Authors and Affiliations
Contributions
Conceptualization, AC, EC, FC, GQ; Methodology, AC, EC, FC; Software, EC, FC; Validation, FB, GQ, RS; Formal analysis, AC, EC, FC; Investigation, AC, EC, GQ, RS; Resources, AC, GQ, FB; Data curation, AC, EC, FC; Writing—original draft preparation, EC, FC; Writing—review and editing, AC, FB, GQ, RS; Supervision, FB, GQ; Project administration, GQ. All authors have read and agreed to the published version of the manuscript.
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Ethics approval
All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments. Informed consent was obtained from all individual participants included in the study.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Crincoli, E., Carnevali, A., Sacconi, R. et al. Differences in structural optical coherence tomography and infrared enface images between non-exudative macular neovascularizations secondary to AMD and pachychoroid disease. Eye 39, 88–93 (2025). https://doi.org/10.1038/s41433-024-03374-w
Received:
Revised:
Accepted:
Published:
Version of record:
Issue date:
DOI: https://doi.org/10.1038/s41433-024-03374-w


