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. 2024 Jan 15:10:1174643.
doi: 10.3389/fmed.2023.1174643. eCollection 2023.

OCT angiography indices and the choroidal vascularity index in wild-type transthyretin (TTR) amyloidosis (ATTRwt)

Michele Rinaldi #  1 , Fausto Tranfa #  2 , Flavia Chiosi  3 , Giuseppe Campagna  4 , Maddalena De Bernardo  5 , Marco Gioia  5 , Francesco Natale  6 , Martina Caiazza  7 , Francesca Dongiglio  7 , Federica Verrillo  7 , Giuseppe Palmiero  7 , Giuseppe Limongelli  7 , Ciro Costagliola  2
Affiliations

OCT angiography indices and the choroidal vascularity index in wild-type transthyretin (TTR) amyloidosis (ATTRwt)

Michele Rinaldi et al. Front Med (Lausanne). .

Abstract

Purpose: Retinal angiopathy represents a well-known ocular manifestation of hereditary transthyretin amyloidosis (ATTRv). Until recently, there have been no reports on retinal changes in ATTRwt. In this retrospective observational clinical study, we aimed to determine whether vessel density (VD) indices and the choroidal vascularity index (CVI) could offer insights into retinal and choroidal vascular changes among patients affected by ATTRwt.

Methods: Eighteen patients with a confirmed diagnosis of ATTRwt underwent structural optical coherence tomography (OCT) and OCT angiography (OCTA). We established a control group consisting of 16 healthy subjects for statistical comparisons. The 3D OCT and OCTA datasets were analyzed to assess retinal and choroidal thickness and VD. For measuring CVI, we obtained measurements for the total choroid area (TCA), luminal area (LA), and stromal area (SA).

Results: The mean VD exhibited a statistically significant reduction in the superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC) among the ATTRwt group in comparison to the control group (p < 0.0001). Notably, ATTRwt patients displayed decreased choroidal thickness (p = 0.08). Additionally, the median CVI was lower in the ATTRwt group than in the control group (p = 0.04).

Conclusion: The indices from OCTA and CVI have the potential to serve as non-invasive biomarkers for the quantitative evaluation of retinal and choroidal vascular involvement in patients with ATTRwt.

Keywords: OCT angiography (OCTA); choroidal vascularity index (CVI); retinal and choroidal microangiopathy; retinal vessel density; wild-type (ATTRwt) transthyretin amyloidosis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(Upper) Right eye of an healthy 67-year-old male shows on Optical Coherence Tomography Angiography (OCTA), a normal vascular texture of the superficial capillary plexus (SCP), the deep capillary plexus (DCP), and choriocapillaris (CC). (Bottom) On OCTA the right eye of an ATTRwt patient (71-year-old male) reveals a reduced foveal vessel density in SCP, DCP, and CC indices.
Figure 2
Figure 2
Example of binarized images for the calculation of choroidal vascularity index (CVI). (A) A 74 y/o healthy male: CVI = 34.01; TCA = 16.20; LCA = 5.51; SCA=10.69. (B) A 74 y/o ATTRwt male patient: CVI = 32.66; TCA = 7.47; LCA = 2.44; SCA = 5.03.
See this image and copyright information in PMC

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