Wide-field choriocapillaris mapping with 3.4 MHz adaptive optics-optical coherence tomography angiography

The human choriocapillaris (CC) plays an essential role in supporting the overlying photoreceptor and retinal pigment epithelial cells and in maintaining overall retinal health. Disruption of CC structure and function is implicated in many retinal diseases, including age-related macular degeneration. Despite recent advances in ophthalmic imaging technologies, a full understanding of disease mechanisms remains elusive due to the inability to visualize CC microstructure. Here, we present a 3.4 MHz adaptive optics-optical coherence tomography angiography (AO-OCTA) approach for mapping the human choriocapillaris at high resolution to address the primary limitations of existing methodologies for CC imaging. We optimized our AO-OCTA acquisition protocols and offered guidelines for performing AO-OCTA for vessel imaging. Our approach achieves high resolution and high contrast CC imaging with single volume acquisition that takes <1 second, allowing rapid montaging and quantification over a 34° field of view. The proposed AO-OCTA method offers a more complete view of the outer retinal neurovascular complex, opening tremendous opportunities to investigate chorioretinal diseases.