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Choroidal imaging biomarkers
Affiliation:1. Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, LV Prasad Eye Institute, Hyderabad, India;2. Retina and Uveitis Department, GMR Varalakshmi Campus, LV Prasad Eye Institute, Visakhapatnam, Andhra Pradesh, India;3. Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA;1. Department of Ophthalmology, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA;2. Departments of Tumor Biology, The Moffitt Cancer Center & Research Institute, Tampa, Florida, USA;3. Cutaneous Oncology The Moffitt Cancer Center & Research Institute, Tampa, Florida, USA;4. Department of Pathology and Cell Biology, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA;1. Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA;2. Infectious Disease Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA;3. Tej Kohli Cornea Institute, L. V. Prasad Eye Institute, Hyderabad, India;1. Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India;2. Gavin Herbert Eye Institute, University of California, Irvine, California, USA;1. Duke University Medical Center, Department of Pathology, Durham, North Carolina, USA;2. Duke University Medical Center, Department of Ophthalmology, Durham, North Carolina, USA;1. Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy;2. Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California, Los Angeles, California, USA;3. Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India;4. Eye Clinic, Public Health Department, University of Naples Federico II, Naples, Italy;5. Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy;6. Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA;7. Ophthalmology Department, San Raffaele University Hospital, Milan, Italy;8. Cleveland Clinic Abu Dhabi, Eye Institute, Abu Dhabi, United Arab Emirates;9. Doheny Eye Institute, University of California, Los Angeles, California, USA;10. Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands;11. Department of Ophthalmology, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands;12. Division of Ophthalmology, Tel Aviv Sourasky Medical Center affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;13. Vitreous Retina Macula Consultants of New York, New York, New York, USA;14. Greater Los Angeles VA Healthcare Center, Los Angeles, California, USA
Abstract:The choroid is the vascular coat of the eye, and its role has been studied in multiple chorioretinal disorders. Recent advancements in choroidal imaging techniques, including enhanced depth imaging optical coherence tomography, swept source optical coherence tomography, en face optical coherence tomography, and optical coherence tomography angiography have facilitated an in-depth analysis of the choroid. The gradual shift from manual to automated segmentation and binarization methods have led to precise and reproducible measurements of choroidal parameters. These qualitative and quantitative parameters, called choroidal imaging biomarkers, have evolved over the past decade from a simple linear subfoveal choroidal thickness to more complex 3D choroidal reconstruction, thus widening the spectrum encompassing multiple parameters. These biomarkers have provided a better understanding of the pathogenesis, are helpful in diagnostic dilemmas, and, in the future may also help to devise treatment options. The lack of normative data, absence of standardized parameters, and limitations of the imaging techniques, however, have led to ambiguity and difficulty in the interpretation of these variables. We attempt to address these lacunae in the literature and provide a basic understanding of the choroid in both health and disease using these choroidal biomarkers.
Keywords:swept source optical coherence tomography (SS-OCT)  optical coherence tomography angiography (OCTA)  choroidal imaging biomarkers  choroidal thickness  choroidal volume  choroidal vascularity index (CVI)  en face OCT
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