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. 2025 Oct;39(15):2774-2779.
doi: 10.1038/s41433-025-03947-3. Epub 2025 Jul 28.

Photoreceptor damage in pachychoroid pigment epitheliopathy

Pasquale Viggiano  1 , Alba Chiara Termite  2 , Giacomo Boscia  2 , Maria Grazia Pignataro  2 , Mariapia Laterza  2 , Arcangelo Clemente  2 , Stefano Dore  3 , Giovanni Alessio  2 , Francesco Boscia  2
Affiliations

Photoreceptor damage in pachychoroid pigment epitheliopathy

Pasquale Viggiano et al. Eye (Lond). 2025 Oct.

Abstract

Purpose: To investigate the relationship between choriocapillaris perfusion and photoreceptor integrity in pachychoroid pigment epitheliopathy (PPE).

Methods: We compared 44 PPE eyes with 30 healthy controls using swept-source OCT angiography to analyse ellipsoid zone reflectivity, choriocapillaris flow deficit percentage (FD%) and retinal capillary perfusion.

Results: PPE eyes showed significantly reduced EZ reflectivity compared to controls (0.73 ± 0.10 vs 0.79 ± 0.05, p = 0.014), increased choriocapillaris ischemia (CC FD%: 46.6 ± 6.3 vs 32.5 ± 2.9, p < 0.001), and reduced deep capillary plexus perfusion (33.1 ± 4.6 vs 38.6 ± 3.3, p < 0.001). Multiple regression analysis revealed a significant inverse association between increased CC ischemia and reduced EZ reflectivity (r = -0.364, p < 0.001).

Conclusion: Choriocapillaris ischemia significantly correlates with photoreceptor damage in PPE, suggesting vascular dysfunction as a key pathogenic mechanism.

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Conflict of interest statement

Competing interests: The authors declare no competing interests.

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