Analysis of choroidal markers of activity in pachychoroid disease spectrum.

Purpose: To detect choroidal markers of disease activity in eyes with chronic active unilateral pachychoroid disease spectrum (PDS) compared to the non-active contralateral eyes, based on multimodal imaging and particularly indocyanine green angiography (ICGA).

Methods: An observational retrospective case-control study. The study evaluated individuals diagnosed with chronic active unilateral PDS (group 1) by comparing the eyes with the non-active fellow eyes (group 2). Imaging was performed using fundus photographs, ICGA, and spectral-domain optical coherence tomography (SD-OCT). Choroidal thickness, choroidal vascular density, choroidal vasodilation, choroidal vascular leakage, and choroidal meridian breakdown were evaluated.

Results: Of the 90 patients with chronic PDS with ICGA at our database, 27 Caucasians (mean age: 55.9 years) were identified with active unilateral PDS. Group 1 showed a higher prevalence of the following parameters compared to Group 2: choroidal meridian breakdown (81.5% vs. 25.9%; p < 0.001), choroidal vasodilation (88.9% vs. 48.1%; p < 0.001), greater subfoveal choroidal thickness (420 ± 79.8 μm vs. 346 ± 78.5 μm; p = 0.002), ICGA choroidal vascular leakage (96.3% vs. 29.6%; p < 0.001), and choroidal hyperpermeability (100% vs. 29.6%; p < 0.001), with a nonsignificant increase in choroidal vascular density (55.4%±13.4 vs. 49.3%±13.5 in the contralateral eye; p = 0.167).

Conclusion: Choroidal meridian breakdown, thicker choroid, choroidal vasodilation, and ICGA choroidal vascular leakage are potential posterior choroidal markers of disease activity in PDS.