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Quantitative changes in the ageing choriocapillaris as measured by swept source optical coherence tomography angiography
  1. Riccardo Sacconi1,2,
  2. Enrico Borrelli3,
  3. Eleonora Corbelli1,
  4. Luigi Capone1,
  5. Alessandro Rabiolo1,
  6. Adriano Carnevali1,4,
  7. Marco Casaluci1,
  8. Francesco Gelormini1,
  9. Lea Querques1,
  10. Francesco Bandello1,
  11. Giuseppe Querques1
  1. 1 Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
  2. 2 Eye Clinic, Department of Neurological, Biomedical and Movement Sciences, University of Verona, Verona, Italy
  3. 3 Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
  4. 4 Department of Ophthalmology, University of ‘Magna Graecia’, Catanzaro, Italy
  1. Correspondence to Professor Giuseppe Querques, Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan 20132, Italy; giuseppe.querques{at}


Aim To analyse quantitative optical coherence tomography angiography (OCTA) parameters of choriocapillaris (CC) at the foveal, perifoveal and parafoveal regions in healthy subjects of different age.

Methods In this observational cross-sectional study, consecutive healthy subjects underwent swept source OCTA (PLEX Elite 9000, Carl Zeiss Meditec, USA). 3×3 mm and 6×6 mm scans centred on the fovea were acquired analysed and postprocessed with thresholding and binarisation processes. The main outcome measures included CC quantitative OCTA features (perfusion density (PD), vessel length density (VLD) and vessel diameter index (VDI)) at the foveal, perifoveal and parafoveal regions, and their relationship with age.

Results Seventy-two eyes (72 patients, mean age 47.4±19.2 years, mean axial length 24.0±0.7 mm) were included. The mean PD was statistically lower in the foveal region compared with the parafoveal region in 3×3 mm scans (p=0.009). In subjects aged 70–80, PD of the foveal region was significantly reduced compared with the perifoveal region in 6×6 mm scans (p=0.008). A strong negative correlation was found between PD and ageing in the foveal, parafoveal and perifoveal regions (p<0.001 in all analyses). Furthermore, PD in the nasal-perifoveal region was significantly lower than the temporal-perifoveal region (p=0.005). No significant correlation was found between VLD and age in all regions, whereas VDI was strictly correlated with age (p<0.001).

Conclusions We reported in vivo a strong negative correlation between PD and ageing in the CC of healthy subjects. This reduction seems related to a reduced diameter, and not to a reduced number, of capillaries. The age-related changes were higher in the central area compared with the perifoveal area.

  • aging
  • choriocapillaris
  • healthy subjects
  • optical coherence tomography angiography
  • perfusion density
  • vessel density
  • vessel diameter index
  • vessel length density
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  • Contributors RS, EB, GQ: research design, data acquisition and analysis, interpretation of data, drafting the manuscript and critical revision of the manuscript. EC, AR, LC, AC, MC, FG: data acquisition and analysis, critical revision of the manuscript. FB, LQ: interpretation of data and critical revision of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests FB is a consultant for Alcon (Fort Worth, Texas, USA), Alimera Sciences (Alpharetta, Georgia, USA), Allergan (Irvine, California, USA), Farmila-Thea (Clermont-Ferrand, France), Bayer Schering Pharma (Berlin, Germany), Bausch and Lomb (Rochester, New York, USA), Genentech (San Francisco, California, USA), Hoffmann-La Roche (Basel, Switzerland), Novagali Pharma (Évry, France), Novartis (Basel, Switzerland), Sanofi-Aventis (Paris, France), Thrombogenics (Heverlee, Belgium) and Zeiss (Dublin, USA). GQ is a consultant for Alimera Sciences (Alpharetta, Georgia, USA), Allergan (Irvine, California, USA), Bayer Schering Pharma (Berlin, Germany), Heidelberg (Germany), Novartis (Basel, Switzerland), Sandoz (Berlin, Germany) and Zeiss (Dublin, USA).

  • Patient consent Obtained.

  • Ethics approval The study adhered to the 1964 Helsinki Declaration and its later amendments. The study was approved by the local institutional review board (Ethics Committee of San Raffaele Hospital).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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