Paquicoróide

Question 1

What defines pachychoroid disease?

Answer 1

Altered choroidal vasculature leading to outer retinal and choriocapillaris damage.

Question 2

What is a key imaging feature of pachychoroid disease?

Answer 2

Presence of pachyvessels.

Question 3

What are pachyvessels?

Answer 3

Dilated outer choroidal vessels originating from Haller’s layer.

Question 4

What is choroidal venous congestion?

Answer 4

Increased venous pressure in choroidal veins, often associated with pachychoroid.

Question 5

How is choroidal thickness (CT) related to pachychoroid?

Answer 5

Initially linked, but now considered less definitive than pachyvessels.

Question 6

Name a disease under the pachychoroid spectrum.

Answer 6

Central serous chorioretinopathy (CSC).

Question 7

What is Pachychoroid Neovasculopathy (PNV)?

Answer 7

Type 1 macular neovascularization linked to pachychoroid features.

Question 8

What is Pachychoroid Pigment Epitheliopathy (PPE)?

Answer 8

RPE alterations without subretinal fluid but associated with pachychoroid.

Question 9

What is Polypoidal Choroidal Vasculopathy (PCV)?

Answer 9

Type 1 MNV with aneurysmal lesions, linked to pachychoroid.

Question 10

How does peripapillary pachychoroid syndrome (PPS) present?

Answer 10

RPE changes near the optic disc without subretinal fluid.

Question 11

How is scleral thickness linked to pachychoroid?

Answer 11

Thicker sclera may restrict vortex vein outflow, causing venous congestion.

Question 12

What role do vortex veins play in pachychoroid disease?

Answer 12

Drain choroidal blood; congestion can lead to pachyvessels.

Question 13

What imaging identifies pachyvessels?

Answer 13

En face OCT and ICGA.

Question 14

Why is OCTA significant in pachychoroid?

Answer 14

Shows choriocapillaris flow impairment and neovascular networks.

Question 15

What is a horizontal watershed zone in pachychoroid?

Answer 15

Limited inter-vortex vein communication observed in pachychoroid cases.

Question 16

What is the ‘Multi-hit theory’ in pachychoroid?

Answer 16

A sequence from predisposition to visual loss.

Question 17

What predisposes individuals to pachychoroid?

Answer 17

Anatomical factors like short axial length and thick sclera.

Question 18

How does stress contribute to CSC?

Answer 18

Triggers disease in predisposed individuals via venous overload.

Question 19

What is the ‘two-hit theory’ in CSC?

Answer 19

A combination of anatomical predisposition and external stressors.

Question 20

How does sleep apnea relate to pachychoroid?

Answer 20

Increases risk of CSC via systemic venous congestion.

Question 21

What is the first-line treatment for CSC?

Answer 21

Half-dose photodynamic therapy (PDT).

Question 22

Why is PDT preferred in CSC treatment?

Answer 22

Targets choroidal hyperpermeability and resolves subretinal fluid.

Question 23

What imaging is used for PDT planning in CSC?

Answer 23

ICGA to map choroidal abnormalities.

Question 24

What is the role of anti-VEGF in pachychoroid?

Answer 24

Treats neovascular complications like PNV and PCV.

Question 25

What is the outcome of untreated chronic CSC?

Answer 25

Risk of retinal pigment epithelial atrophy and visual loss.

Question 26

How does ultra-widefield ICGA aid in pachychoroid study?

Answer 26

Maps extensive vortex vein abnormalities.

Question 27

What does en face OCT reveal in pachychoroid?

Answer 27

Dilated choroidal veins and pachyvessels.

Question 28

What is the significance of choroidal hyperpermeability?

Answer 28

Indicates active pachychoroid disease areas.

Question 29

What is SIRE on OCT in pachychoroid?

Answer 29

Shallow irregular RPE elevation seen in PNV.

Question 30

What defines pachydrusen in pachychoroid?

Answer 30

Thick drusen overlying pachyvessels.

Question 31

What complications arise from pachychoroid?

Answer 31

RPE atrophy, neovascularization, and visual loss.

Question 32

What differentiates PCV from AMD?

Answer 32

Presence of aneurysmal lesions in PCV.

Question 33

How is macular neovascularization detected in PNV?

Answer 33

OCTA shows a vascular network under RPE.

Question 34

Why is PNV monitoring crucial?

Answer 34

Risk of progression to exudative neovascularization.

Question 35

What happens in the decompensation stage of pachychoroid?

Answer 35

Chronic venous stasis leads to retinal damage.

Question 36

What population has a higher prevalence of pachychoroid?

Answer 36

Asian populations.

Question 37

How does pachychoroid differ in Caucasian eyes?

Answer 37

Less prevalence of pachyvessels and choroidal hyperpermeability.

Question 38

What is the gender predilection for CSC?

Answer 38

More common in males.

Question 39

What age group is most affected by pachychoroid?

Answer 39

Middle-aged individuals.

Question 40

How does smoking influence pachychoroid?

Answer 40

May exacerbate venous congestion and neovascular risk.

Question 41

What are current research gaps in pachychoroid?

Answer 41

Lack of clear flow dynamics and consistent definitions.

Question 42

How do animal models aid pachychoroid research?

Answer 42

Show effects of venous ligation mimicking congestion.

Question 43

What is the role of genetics in pachychoroid?

Answer 43

Under investigation, potentially linked to predisposition.

Question 44

How does vortex vein asymmetry relate to pachychoroid?

Answer 44

Congenital asymmetry may predispose to venous congestion.

Question 45

What imaging advancements could benefit pachychoroid study?

Answer 45

Improved OCTA for detailed vascular mapping.

Question 46

Why is pachychoroid diagnosis challenging?

Answer 46

Overlap with other retinal diseases.

Question 47

What limits the use of choroidal thickness in diagnosis?

Answer 47

Overlap between healthy and diseased eyes.

Question 48

What is a critical diagnostic tool for pachychoroid?

Answer 48

Multimodal imaging.

Question 49

How is pachychoroid spectrum classified?

Answer 49

By disease-specific features like CSC, PNV, PCV.

Question 50

What diagnostic role does fundus autofluorescence play?

Answer 50

Shows RPE changes and tracks pachydrusen distribution.