Peripapillary pachychoroid syndrome, a different pathway in venous remodelling of the choroidal vasculature
Objective: Peripapillary pachychoroid syndrome (PPS) is a recently described syndrome belonging to the pachychoroid disease spectrum (PDS) group.Our aim is to demonstrate with PPS, the presence of a venous collateral circulation which joins the peripapillary choroidal venous system with the central...
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Elsevier
2025-03-01
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| Series: | American Journal of Ophthalmology Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993625000015 |
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| author | Giuseppe Donvito Vito Primavera |
| author_facet | Giuseppe Donvito Vito Primavera |
| author_sort | Giuseppe Donvito |
| collection | DOAJ |
| description | Objective: Peripapillary pachychoroid syndrome (PPS) is a recently described syndrome belonging to the pachychoroid disease spectrum (PDS) group.Our aim is to demonstrate with PPS, the presence of a venous collateral circulation which joins the peripapillary choroidal venous system with the central retinal vein via the circulation of the prelaminar region.This collateral circulation reduces venous congestion of the nasal choroid secondary to outflow obstruction through the vortex veins or the choroidopial veins.It is also our intention to demonstrate with a retrospective analysis, the stages of development and possible spontaneous regression of the illness. Observation: We describe the clinical evolution of a patient affected by PPS over a 5-year period. Conclusion and importance: The increased outflow resistance via the vortex veins, as observed in patients affected by PDS, is the cause of congestion of the choroid and related chorioretinal manifestations.Vortex veins anastomosis in the watershed zones develops to compensate stasis.We believe that in the PPS cases we observed, and in each case of PPS, the increased venous choroidopial outflow resistance at the level of the nasal macular choroid determines the formation of a collateral circulation which develops between the peripapillary choroid and the central retinal vein, passing through the prelaminar region.Furthermore, this study highlights how stages of disease activity can quickly be followed by major structural changes in the outer retina.This suggests that treatment should not be delayed if the disease involves the central retina. |
| format | Article |
| id | doaj-art-2daefc9425654fd29b62c6a24b22d3b9 |
| institution | DOAJ |
| issn | 2451-9936 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj-art-2daefc9425654fd29b62c6a24b22d3b92025-08-20T02:43:20ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362025-03-013710224810.1016/j.ajoc.2025.102248Peripapillary pachychoroid syndrome, a different pathway in venous remodelling of the choroidal vasculatureGiuseppe Donvito0Vito Primavera1Corresponding author. Ospedale della Murgia ASL BA, Strada Statale 96 per Gravina in Puglia Km 74,800, Altamura, BA, Italy,; Department of Ophthalmology, Ospedale della Murgia ASL Bari, Strada Statale 96 per Gravina in Puglia Km 74,800, CAP 70022, Altamura, BA, ItalyDepartment of Ophthalmology, Ospedale della Murgia ASL Bari, Strada Statale 96 per Gravina in Puglia Km 74,800, CAP 70022, Altamura, BA, ItalyObjective: Peripapillary pachychoroid syndrome (PPS) is a recently described syndrome belonging to the pachychoroid disease spectrum (PDS) group.Our aim is to demonstrate with PPS, the presence of a venous collateral circulation which joins the peripapillary choroidal venous system with the central retinal vein via the circulation of the prelaminar region.This collateral circulation reduces venous congestion of the nasal choroid secondary to outflow obstruction through the vortex veins or the choroidopial veins.It is also our intention to demonstrate with a retrospective analysis, the stages of development and possible spontaneous regression of the illness. Observation: We describe the clinical evolution of a patient affected by PPS over a 5-year period. Conclusion and importance: The increased outflow resistance via the vortex veins, as observed in patients affected by PDS, is the cause of congestion of the choroid and related chorioretinal manifestations.Vortex veins anastomosis in the watershed zones develops to compensate stasis.We believe that in the PPS cases we observed, and in each case of PPS, the increased venous choroidopial outflow resistance at the level of the nasal macular choroid determines the formation of a collateral circulation which develops between the peripapillary choroid and the central retinal vein, passing through the prelaminar region.Furthermore, this study highlights how stages of disease activity can quickly be followed by major structural changes in the outer retina.This suggests that treatment should not be delayed if the disease involves the central retina.http://www.sciencedirect.com/science/article/pii/S2451993625000015Peripapillary pachychoroid syndrome (PPS)Pachychoroid disease spectrum (PDS) groupVenous collateral circulation of the choroidCirculation of the prelaminar region |
| spellingShingle | Giuseppe Donvito Vito Primavera Peripapillary pachychoroid syndrome, a different pathway in venous remodelling of the choroidal vasculature American Journal of Ophthalmology Case Reports Peripapillary pachychoroid syndrome (PPS) Pachychoroid disease spectrum (PDS) group Venous collateral circulation of the choroid Circulation of the prelaminar region |
| title | Peripapillary pachychoroid syndrome, a different pathway in venous remodelling of the choroidal vasculature |
| title_full | Peripapillary pachychoroid syndrome, a different pathway in venous remodelling of the choroidal vasculature |
| title_fullStr | Peripapillary pachychoroid syndrome, a different pathway in venous remodelling of the choroidal vasculature |
| title_full_unstemmed | Peripapillary pachychoroid syndrome, a different pathway in venous remodelling of the choroidal vasculature |
| title_short | Peripapillary pachychoroid syndrome, a different pathway in venous remodelling of the choroidal vasculature |
| title_sort | peripapillary pachychoroid syndrome a different pathway in venous remodelling of the choroidal vasculature |
| topic | Peripapillary pachychoroid syndrome (PPS) Pachychoroid disease spectrum (PDS) group Venous collateral circulation of the choroid Circulation of the prelaminar region |
| url | http://www.sciencedirect.com/science/article/pii/S2451993625000015 |
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