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      Topographic distribution of choriocapillaris flow deficits in healthy eyes

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          Abstract

          Purpose

          To evaluate the topographic distribution of the choriocapillaris (CC) flow deficits in a population of healthy subjects.

          Methods

          Using a swept-source optical-coherence tomography angiography (SS-OCTA) device, two repeated volume 6 x 6 mm and 3 x 3 mm scans were acquired in healthy subjects at the Doheny—UCLA Eye Centers. The en-face CC angiogram was binarized and analyzed for percentage of flow deficits (FD%) using a grid of progressive, concentric rings covering a circular area with a diameter of 2.5 mm (in the 3 x 3 mm scans) and 5 mm (in the 6 x 6 mm scans). The FD% for each ring was plotted against the distance from the fovea. The linear trendline of the resulting curve was analyzed and the slope ( m) and intercept ( q) were computed.

          Results

          Seventy-five eyes of 75 subjects were enrolled and divided into three subgroups based on age (year ranges: 21–40, 41–60 and 61–80). For the entire cohort and within each subgroup, there was a significant association between distance from the fovea and FD% in both 3X3 mm and 6X6 mm scans, with flow deficits increasing with closer proximity to the foveal center. Age was a significant predictor for both m and q for both scan patterns, with older subjects showing a steeper slope.

          Conclusions

          In SS-OCTA images, the topographic distribution of CC flow deficits varies with distance from the fovea and age. In particular, the FD% tends to decrease from the fovea towards the periphery, with a steeper decline with advancing age. These normal trends may need to be accounted for in future studies of the CC in disease.

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          Most cited references5

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          NIH Image to ImageJ: 25 years of image analysis.

          For the past 25 years NIH Image and ImageJ software have been pioneers as open tools for the analysis of scientific images. We discuss the origins, challenges and solutions of these two programs, and how their history can serve to advise and inform other software projects.
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            Morphometric analysis of Bruch's membrane, the choriocapillaris, and the choroid in aging.

            To quantify changes in choriocapillary density and in thickness of Bruch's membrane, the choriocapillaris, and the choroid in 95 unpaired, histologically normal human maculae aged 6 to 100 years and in 25 maculae with advanced age-related macular degeneration. Light microscopic, computer-aided, morphometric quantitative analysis. In ten decades, Bruch's membrane thickness increased by 135%, from 2.0 to 4.7 microns; the choriocapillary density decreased by 45%; the diameter of the choriocapillaris decreased by 34%, from 9.8 to 6.5 microns; and the choroidal thickness decreased by 57%, from 193.5 to 84 microns in normal maculae. In maculae with basal laminar deposit, geographic atrophy, or disciform scarring, the density of the choriocapillaris was 63%, 54%, and 43% of normal and the choriocapillary diameter was 81%, 73%, and 75% of normal, respectively. Choroidal thickness remained unchanged. Thickness of Bruch's membrane was only related to age (rs = 0.63) and not to age-related atrophy of the choriocapillaris. Age was also the strongest factor related to choriocapillary density (rs = -0.58). In advanced stages of age-related macular degeneration, the decrease in choriocapillary density and diameter was significantly larger than in normal maculae, but the thickness of the choroid and Bruch's membrane was the same. The latter was significantly thinner (81% of normal) in disciform scarring.
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              Spatial distribution of posterior pole choroidal thickness by spectral domain optical coherence tomography.

              To study the spatial distribution of posterior pole choroidal thickness (CT) in healthy eyes using spectral domain optical coherence tomography (SD-OCT).
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Writing – original draft
                Role: Data curationRole: Formal analysisRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: MethodologyRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: Writing – review & editing
                Role: ConceptualizationRole: MethodologyRole: SupervisionRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                15 November 2018
                2018
                : 13
                : 11
                : e0207638
                Affiliations
                [1 ] Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, California, United States of America
                [2 ] Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America
                [3 ] Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
                Massachusetts Eye & Ear Infirmary, Harvard Medical School, UNITED STATES
                Author notes

                Competing Interests: I have read the journal's policy and the authors of this manuscript have the following competing interests: M. Nassisi: none; E. Baghdasaryan: none; T. Tepelus: none; S. Asanad: none; E. Borrelli: none; S.R. Sadda: Allergan (C,F), Carl Zeiss Meditec (F), Genentech (C, F), Iconic (C), Novartis (C), Optos (C,F), Optovue (C, F), Regeneron (F), Thrombogenics (C). This does not alter our adherence to PLOS ONE policies on sharing data and materials.

                Author information
                http://orcid.org/0000-0002-9354-9005
                http://orcid.org/0000-0003-2815-5031
                Article
                PONE-D-18-25326
                10.1371/journal.pone.0207638
                6237387
                30440050
                dea3a907-1cb7-4cad-b1f3-aa3f0fb1883e
                © 2018 Nassisi et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 28 August 2018
                : 2 November 2018
                Page count
                Figures: 5, Tables: 3, Pages: 13
                Funding
                The authors received no specific funding for this work.
                Categories
                Research Article
                Biology and Life Sciences
                Anatomy
                Ocular System
                Ocular Anatomy
                Fovea Centralis
                Medicine and Health Sciences
                Anatomy
                Ocular System
                Ocular Anatomy
                Fovea Centralis
                Medicine and Health Sciences
                Diagnostic Medicine
                Diagnostic Radiology
                Tomography
                Research and Analysis Methods
                Imaging Techniques
                Diagnostic Radiology
                Tomography
                Medicine and Health Sciences
                Radiology and Imaging
                Diagnostic Radiology
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                Medicine and Health Sciences
                Cardiovascular Medicine
                Cardiovascular Imaging
                Angiography
                Medicine and Health Sciences
                Diagnostic Medicine
                Diagnostic Radiology
                Cardiovascular Imaging
                Angiography
                Research and Analysis Methods
                Imaging Techniques
                Diagnostic Radiology
                Cardiovascular Imaging
                Angiography
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                Radiology and Imaging
                Diagnostic Radiology
                Cardiovascular Imaging
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                Biology and Life Sciences
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                Medicine and Health Sciences
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                Biology and Life Sciences
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                Medicine and Health Sciences
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