![]() Additionally, choroidal thickness (ChT) is a sensitive biomarker in the prediction, diagnosis, intervention, and follow-up of various acute or chronic retinal and choroidal diseases, including polypoidal choroidal vasculopathy (PCV), central serous chorioretinopathy (CSCR), and idiopathic macular hole (IMH) ( 2– 4). The dysfunction of the choroid has been implicated in various retinal and choroidal diseases. ![]() As the main source of blood supply to the retinal epithelium, the outer retina, and the optic nerve, the choroid plays a significant role in maintaining the normal metabolism of the retinal pigment epithelium (RPE) and photoreceptors ( 1). The choroid is mainly composed of blood vessels and is the posterior portion of the uveal tract with rich and slow blood flow. The present review highlights the recently available evidence on the measurement methodology and the clinical significance of choroidal thickness in retinal or choroidal disorders. The recent rapid revolution of OCTs, such as the enhanced depth imaging OCT and the swept-source OCT, has greatly contributed to the significant improvement in the analysis of the morphology and physiology of the choroid precisely, especially to the choroid–scleral boundary and vasculature. The identification and in-depth understanding of pachychoroid spectrum disorders are based on the tremendous progress of optical coherence tomography (OCT) technology in recent years, although visibility of choroid is challenging in the era of the time or spectral domain OCT. The choroid is the main source of blood and nourishment supply to the eye. 3The University of Pittsburgh Medical Center Eye Center, University of Pittsburgh, Pittsburgh, PA, United States.2Beijing Retinal and Choroidal Vascular Diseases Study Group, Beijing, China.1Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Tongren Hospital, Capital Medical University, Beijing, China.The use of intra-vessel imaging.Rui Xie 1,2 Bingjie Qiu 1,2 Jay Chhablani 3 Xinyuan Zhang 1,2 * The BPA is an emerging method of treatment of patients with inoperable CTEPH. m2) and 6-minute walking test (6-MWT) increased to 430 m.Three more BPA sessions at intervals of a few weeks were performed and mPAP was reduced to 29 mm Hg (mRAP – 7 mm Hg, PCWP – 13 mm Hg, PVR – 167 dyn Four inflations of a 2.0 mm × 20 mm semi-compliant balloon with the pressure of 4–10 atm were performed along the entire artery with good angiographic and hemodynamic effects (Figure 1 C). The diameter of the vessel was 2.23 mm × 2.42 mm. Surprisingly, OCT revealed extensive changes in the proximal and mid part of the target artery (“colander lesions” or meshwork) (Figure 1 B). Subsequently the vessel was accurately measured in several locations and the proper size of the balloon was selected to reduce the risk of post-reperfusion oedema. Iodinated contrast was infused at a flow rate of 5 ml/s over 4 s at 400 psi of pressure and OCT images were acquired. Then optical coherence tomography (OCT) of the target vessel was performed with the DragonFly (St. Subsequently a Whisper MS coronary guidewire (Abbott Vascular, Santa Clara, Ca, USA) was advanced through the lesion to the distal part of the vessel. Selective pulmonary angiography revealed the subtotally occluded A1 segmental branch of the left pulmonary artery (Figure 1 A). The 90-cm long 6Fr sheath (Flexor Shuttle Guiding Sheath, Cook Medical, Bloomington, IN, USA) and right Judkins 6-Fr guide catheter were used to achieve a good approach to the ostium of the A1 + A2 segmental branch. The BPA was performed from a right femoral vein approach. Functional testing demonstrated a reduced 6-minute walk distance of 220 m. m2) and pulmonary scintigraphy showed multiple segmental perfusion defects (segments 1, 2, 8, 9 in the left lung and 2, 3, 4, 5, 6 in the right lung).Right heart catheterisation confirmed pulmonary hypertension (mean pulmonary artery pressure (mPAP) 37 mm Hg, mean right atrial pressure (mRAP) 6 mm Hg, pulmonary capillary wedge pressure (PCWP) 13 mm Hg, pulmonary vascular resistance (PVR) 214 dyn A 71-year-old woman with non-operable, peripheral type chronic thrombo-embolic pulmonary hypertension (CTEPH) and with World Health Organisation (WHO) class III dyspnoea was admitted to our department for balloon pulmonary angioplasty (BPA).
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