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Choroidal luminal and stromal areas and choriocapillaris perfusion are characterised by a non-linear quadratic relation in healthy eyes
  1. Enrico Borrelli1,
  2. Maria Cristina Gabela2,
  3. Riccardo Sacconi1,
  4. Lea Querques1,
  5. Giovanna Vella1,3,
  6. Biancamaria Zuccaro1,
  7. Francesco Gelormini1,
  8. Francesco Bandello1,
  9. Giuseppe Querques1
  1. 1 Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
  2. 2 Hospital Metropolitano, Quito, Ecuador
  3. 3 Ophthalmology, Department of Surgical, Medical, Molecular Pathology and of Critical Area, University of Pisa, Pisa, Italy
  1. Correspondence to Professor Giuseppe Querques, Department of Ophthalmology, Ospedale San Raffaele, Milano 20132, Italy; giuseppe.querques{at}


Purpose To assess the associations among different optical coherence tomography (OCT) structural and angiography quantitative metrics used to characterise the choroid in healthy subjects.

Methods In this cross-sectional study, macular structural OCT and OCT angiography (OCTA) images were acquired from healthy subjects. The main outcome measures were: (i) choriocapillaris (CC) flow deficits percentage (FD%), (ii) choroidal luminal (LA) and stromal (SA) areas and (iii) choroidal vascularity index (CVI), which was calculated as the LA divided by the total choroidal area. These measurements were generated using previously published algorithms and were separately computed in the foveal and extrafoveal regions.

Results Eighty-five eyes from 85 subjects (44 males, 41 females) were included in the analysis. Mean±SD age was 47.9±22.4 years (range: 19.0 to 85.0 years). Linear regression analysis displayed no significant associations between CC FD% and other parameters (LA, SA and CVI). Importantly, non-linear regression analysis showed that the relations of LA and SA to CC FD% were all best fitted by a quadratic function. Compared with the linear models, the use of the quadratic function allowed a relative increase in the R2 coefficients. No significant non-linear associations were found between CC FD% and CVI.

Conclusion Based on our models, changes in the luminal and stromal areas in the choroid lead to an initial increase in CC perfusion. Subsequently, further increases in LA and SA amounts are accompanied by a progressive increment in CC FD%.

  • choroid
  • imaging

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  • Contributors Study concept and design: EB and GQ. Acquisition, analysis or interpretation of data: All authors. Drafting of the manuscript: EB and GQ. Critical revision of the manuscript for important intellectual content: All authors. Statistical analysis: EB. Study supervision: EB and GQ.

  • 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 Inc (Irvine, California, USA), Farmila-Thea (Clermont-Ferrand, France), Bayer Shering-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), Zeiss (Dublin, USA). GQ is a consultant for: Alimera Sciences (Alpharetta, Georgia, USA), Allergan Inc (Irvine, California, USA), Amgen (Thousand Oaks, USA), Bayer Shering-Pharma (Berlin, Germany), Heidelberg (Germany), KBH (Chengdu; China), LEH Pharma (London, UK), Lumithera (Poulsbo; USA), Novartis (Basel, Switzerland), Sandoz (Berlin, Germany), Sifi (Catania, Italy), Sooft-Fidea (Abano, Italy), Zeiss (Dublin, USA).

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the San Raffaele Ethics Committee.

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

  • Data availability statement Data are available upon reasonable request. Data will be made available upon request to the corresponding author.

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