Pachyvessels are pathologically dilated large choroidal vessels and are associated with the pathogenesis of several pachychoroid-related disorders, including central serous chorioretinopathy. We aimed to investigate the prevalence of and risk factors for pachyvessels in the Japanese population. We included 316 participants (aged ≥ 40 years) with normal right eyes. The presence of pachyvessels (vertical diameter > 300 µm, distance to the retinal pigment epithelium < 50 µm) was determined using 6 × 6 mm macular swept-source optical coherence tomography images, and associated risk factors were investigated. Subfoveal choroidal thickness was measured, and its associated risk factors investigated. The overall prevalence of pachychoroids was 9.5%. Regression analysis showed that a younger age, shorter axial length, male sex, and smoking were significantly associated with the presence of pachyvessels (p = 0.047; odds ratio [OR] 0.96 per year, p = 0.021; OR 0.61 per 1 mm, p = 0.012; OR 3.08 vs. female, and p = 0.011; OR 3.15 vs. non-smoker, respectively) and greater choroidal thickness (p < 0.001, p < 0.001, p < 0.003, and p < 0.017, respectively). The results were consistent with other research findings which showed that pachychoroid-related disorders such as central serous chorioretinopathy were associated with younger age, male sex, shorter axial length, and smoking. Smoking may be associated with choroidal circulatory disturbance in the Japanese population.
Pachyvessels are large, inwardly displaced, pathologically dilated choroidal vessels. Pachyvessels can cause focal choriocapillaris thinning and are associated with the pathogenesis of central serous chorioretinopathy (CSC)1. In optical coherence tomography (OCT) angiography images of CSC eyes, the area of choriocapillaris flow void was found to be high2, and the location of the choriocapillaris flow void was associated with the distribution of the underlying choroidal vessels3,4. Studies suggest that pachyvessels impair choriocapillaris and may be responsible for retinal pigment epithelium (RPE) damage, resulting in CSC. Therefore, pachyvessels may be a preclinical sign of CSC, and normal eyes with pachyvessels may have a potential risk of CSC.
Baek et al. reported that the prevalence of pachyvessels was 25%, 46%, 85%, 96%, and 100% in non-neovascular age-related macular degeneration (AMD), neovascular AMD, thin choroid polypoidal choroidal vasculopathy (PCV), thick choroid PCV, and CSC eyes, respectively5. However, the prevalence of pachyvessels in the normal healthy population without degenerative disease has not been studied. Thus, investigation of pachyvessel prevalence will increase understanding of its pathogenesis in CSC, PCV, and AMD. Therefore, our study evaluated the prevalence of pachyvessels and associated risk factors in a normal Japanese population. In addition, the risk factors associated with increased subfoveal choroidal thickness were studied.
Source :nature
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