Choriocapillaris: Fundamentals and advancements

Raphael Lejoyeux; Jennifer Benillouche; Joshua Ong; Marie-Hélène Errera; Ethan A Rossi; Sumit R Singh; Kunal K Dansingani; Susana da Silva; Debasish Sinha; José-Alain Sahel; K Bailey Freund; SriniVas R Sadda; Gerard A Lutty; Jay Chhablani

doi:10.1016/j.preteyeres.2021.100997

Choriocapillaris: Fundamentals and advancements

Prog Retin Eye Res. 2022 Mar:87:100997. doi: 10.1016/j.preteyeres.2021.100997. Epub 2021 Jul 19.

Authors

Affiliations

¹ Rothschild Foundation, 75019, Paris, France.
² Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
³ Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, PA 15213, USA.
⁴ Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, San Diego, CA, USA.
⁵ Department of Ophthalmology and Department of Developmental Biology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
⁶ Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; Department of Cell Biology and Center for Biologic Imaging, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
⁷ Rothschild Foundation, 75019, Paris, France; Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France; CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, Paris, France.
⁸ LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, NY, USA; Vitreous Retina Macula Consultants of New York, New York, NY, USA; Department of Ophthalmology, New York University of Medicine, New York, NY, USA; Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, NY, USA.
⁹ Doheny Image Reading Center, Doheny Eye Institute, Los Angeles, CA, 90033, USA; Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
¹⁰ Wilmer Ophthalmological Institute, Johns Hopkins Hospital, Baltimore, MD, 21287, USA.
¹¹ Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. Electronic address: jay.chhablani@gmail.com.

PMID: 34293477
DOI: 10.1016/j.preteyeres.2021.100997

Abstract

The choriocapillaris is the innermost structure of the choroid that directly nourishes the retinal pigment epithelium and photoreceptors. This article provides an overview of its hemovasculogenesis development to achieve its final architecture as a lobular vasculature, and also summarizes the current histological and molecular knowledge about choriocapillaris and its dysfunction. After describing the existing state-of-the-art tools to image the choriocapillaris, we report the findings in the choriocapillaris encountered in the most frequent retinochoroidal diseases including vascular diseases, inflammatory diseases, myopia, pachychoroid disease spectrum disorders, and glaucoma. The final section focuses on the development of imaging technology to optimize visualization of the choriocapillaris as well as current treatments of retinochoroidal disorders that specifically target the choriocapillaris. We conclude the article with pertinent unanswered questions and future directions in research for the choriocapillaris.

Keywords: Choriocapillaris; Choroid; Macula; OCT; OCTA; Uvea.

Publication types

Review

MeSH terms

Choroid / blood supply*
Fluorescein Angiography / methods
Glaucoma* / pathology
Humans
Retinal Diseases* / diagnostic imaging
Retinal Diseases* / pathology
Retinal Pigment Epithelium / blood supply
Retinal Pigment Epithelium / pathology
Tomography, Optical Coherence* / methods