Submacular Choroidal Arteries

IF 3.2 Q1 OPHTHALMOLOGY

Ophthalmology science Pub Date : 2025-01-13 DOI:10.1016/j.xops.2025.100709

Michel Paques MD, PhD , Zosia Bratasz PhD , Leo Puyo PhD , Céline Chaumette BS , Daniela Castro Farias MD , Michael Atlan PhD , Sarah Mrejen MD

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Abstract

Objective

To document the aspect, topography and morphometry of normal human choroidal arteries in the posterior pole by laser Doppler holography (LDH) and OCT.

Design

Cross-sectional study.

Subjects

Fifty-four eyes of 27 healthy subjects.

Methods

A prototypic LDH system captured the laser Doppler shift of the choroidal circulation within the central 20°. Doppler shifts were filtered to extract high velocity vessels. Images of choroidal arteries identified by LDH were subsequently registered with en face and cross-sectional OCT images. Subsequently, the diameters of macular choroidal arteries and their correlation to central choroidal thickness was measured on OCT B-scans.

Main Outcome Measures

Spatial disposition, distribution, and diameters of choroidal arteries.

Results

Choroidal arteries were identified by LDH and OCT from their emergence from short posterior ciliary arteries (sPCAs), and could be traced to second and third divisions. In the 8 eyes that underwent LDH, 7 of 8 (88%) showed a horizontal first-order artery within 0.5 disc diameter from the fovea. OCT B-scans showed that first-order arteries were located along the sclera-choroid interface; around arteries, the choroidal tissue formed a pyramid-shaped avascular structure with a posterior base contiguous and isoreflective to the sclera. In a cohort of 49 eyes, the diameter of horizontal submacular arteries (average [± standard deviation] 136.3 μm [±47]; range, 70–209 μm) was weakly correlated to central choroidal thickness (P = 0.09).

Conclusions

First-order choroidal arteries emerging from sPCAs are located along the sclerochoroidal interface and are surrounded by a pyramid-shaped avascular space, which contributes to differentiate them from veins. The majority of normal eye show a submacular first-order artery running horizontally toward the temporal periphery. These results will pave the way for a better knowledge of diseases affecting the choroidal circulation.