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Topographical relationship between the choroidal watershed zone and submacular idiopathic choroidal neovascularisation
  1. Ji Eun Lee1,2,
  2. Min Kyu Shin1,2,
  3. In Young Chung3,
  4. Joo Eun Lee4,
  5. Hyun Woong Kim5,
  6. Sang Joon Lee6,7,
  7. Sung Who Park1,2,
  8. Ik Soo Byon1,8
  1. 1Department of Ophthalmology, College of Medicine, Pusan National University, Yangsan, Republic of Korea
  2. 2Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
  3. 3Department of Ophthalmology, Gyeongsang National University, JinJu, Republic of Korea
  4. 4Department of Ophthalmology, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Republic of Korea
  5. 5Department of Ophthalmology, Busan Paik Hospital, College of Medicine, Inje University, Busan, Republic of Korea
  6. 6Department of Ophthalmology, Gospel hospital, College of Medicine, Kosin University, Busan, Republic of Korea
  7. 7Institute for medicine, Kosin University, Busan, Republic of Korea
  8. 8Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
  1. Correspondence to Professor Ji Eun Lee, Department of Ophthalmology, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan 602-739, Republic of Korea; jlee{at}


Aims To investigate the relationship between idiopathic choroidal neovascularisation (CNV) and choroidal watershed zones (CWZs) using indocyanine green angiography (ICGA).

Design Multicentre, retrospective, interventional case series.

Methods The medical records and ICGA findings of 44 patients (44 eyes) diagnosed with idiopathic CNV were reviewed. CWZs, defined as hypofluorescence that disappeared during the early phase of ICGA, were classified, and the findings were compared with those of a control group of 30 eyes. The topographical relationship between CWZs and CNV was evaluated. Visual acuity and recurrence were analysed according to the CWZ classification.

Results The CNV lesion was subfoveal in 16 eyes, juxtafoveal in 12 eyes and extrafoveal in 16 eyes. The most common types of CWZs were stellate (23 eyes, 52.3%) and vertical (19 eyes, 43.2%). CWZs involving the fovea were seen in more patients with idiopathic CNV (37 eyes, 84.1%) than in the control group (11 eyes, 36.7%, p<0.001). The topographical relationship between CWZs and CNV was determined in 42 eyes (95.5%), with the CNV located within the CWZ in 39 eyes and at the margin in 3 eyes. Extrafoveal CNV was within the CWZ in all 16 affected eyes. At 6 months, visual acuity was significantly worse in patients with subfoveal CNV (p=0.028) or stellate CWZs (p=0.039).

Conclusions The findings of a CWZ were related to the location and functional outcome of idiopathic CNV. Our results suggest that choroidal circulation is a predisposing factor for the development of CNV in young patients.

  • Choroid
  • Neovascularisation
  • Imaging

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