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Optical Coherence Tomography Angiography for Diagnosis of Choroidal Neovascularization in Chronic Central Serous Chorioretinopathy after Photodynamic Therapy.

ABSTRACT: The authors evaluated the proportion of choroidal neovascularization (CNV) detected by spectral-domain optical coherence tomography angiography (OCTA) in eyes with chronic central serous chorioretinopathy (CSC) (more than 3 months) with previous treatment via half-dose photodynamic therapy (PDT). All patients were followed up with at least twelve months. Macular angiograms were obtained using spectral-domain OCT (SD-OCT, RTVue XR; Optovue). CNV was defined as flow in the outer retinal slab between the outer plexiform layer and Bruch's membrane. Clinical characteristics were compared between CNV and non-CNV groups. Seventy eyes of 61 patients (51 male and 10 female) were included. The average age was 46.2 years old. The average duration of symptom was 32.9 months. All patients were treated with half-dose PDT initially. Eleven eyes (15.7%) received more than one session of PDT. CNV was diagnosed in 32 of 70 eyes (45.7%) based on OCTA. Only 6 of the 32 eyes (18.8%) needed intravitreal anti- vascular endothelial growth factor (VEGF) therapy for the exudative activity of CNV. Older age (p?=?0.059), larger PDT spot size (p?=?0.024), and thinner subfoveal choroidal thickness (p?=?0.008) were noted in CNV group. The authors conclude that OCTA reveals high rates of CNV associated with chronic CSC after PDT. Patients in the CNV group had older age, larger PDT spot size, and thinner subfoveal choroidal thickness. OCTA may be considered as a first step in identifying CNV in chronic CSC following PDT.

SUBMITTER: Wu JS

PROVIDER: S-EPMC6588615 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Optical Coherence Tomography Angiography for Diagnosis of Choroidal Neovascularization in Chronic Central Serous Chorioretinopathy after Photodynamic Therapy.

Wu Jian-Sheng JS Chen San-Ni SN

Scientific reports 20190621 1

The authors evaluated the proportion of choroidal neovascularization (CNV) detected by spectral-domain optical coherence tomography angiography (OCTA) in eyes with chronic central serous chorioretinopathy (CSC) (more than 3 months) with previous treatment via half-dose photodynamic therapy (PDT). All patients were followed up with at least twelve months. Macular angiograms were obtained using spectral-domain OCT (SD-OCT, RTVue XR; Optovue). CNV was defined as flow in the outer retinal slab betwe ...[more]

PMID: 31227727

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Project description:BackgroundTo map and compare the three-dimensional choroidal vascularity index (3D-CVI) in eyes with unilateral central serous chorioretinopathy (CSC), fellow eyes and control eyes using ultra-widefield swept source optical coherence tomography (UWF SS-OCTA).MethodsIn this prospective observational study, the 3D-CVIs were measured in 9 subfields or 1 × 1 mm grids by the UWF SS-OCTA with a viewing angle of horizontal 24 × vertical 20 mm. The proportions of vortex vein anastomoses and their corresponding CVI in the central regions were compared among the CSC, fellow and control eyes. Correlations of CVI and vascular density of the large choroidal vessel layer/choriocapillaris layer/choroidal thickness (CT) were also assessed.ResultsThirty-two eyes in 32 patients with unilateral CSC and 32 normal eyes were included in the study. The mean CVI in the eyes with CSC was significantly greater than that in the fellow eyes of CSC and control eyes (41.99 ± 3.56% vs. 40.38 ± 3.855%, P = 0.003; 41.99 ± 3.56% vs. 38.93 ± 4.067%, P = 0.004, respectively). The CVIs in superotemporal, inferotemporal and inferonasal regions were significantly higher in CSC eyes than control eyes (P = 0.03, P = 0.02, P = 0.008). In CSC eyes, there was a linear positive correlation between 3D-CVI and vascular density of the large choroidal vessel layer and CT in all subfields. The proportion of vortex vein anastomoses in CSC was 25/32 (78.1%), and significantly higher in fellow and control eyes (P < 0.001). The average central CVI was significantly higher in CSC eyes with anastomoses than in CSC eyes without anastomoses (42.8 ± 5.1% vs. 38.4 ± 2.7%, P = 0.039). CVIs in superior, central, inferior, superonasal, nasal and inferonasal regions were significantly correlated with vortex vein anastomoses (P < 0.05), regardless of CSC, fellow or healthy eyes. In addition, whether there were vortex vein anastomoses, CVI in superotemporal region was significantly higher in eyes with CSC (P = 0.002) and fellow eyes (P = 0.014), compared to control eyes. No significant correlation was found between hypertension and CVIs in the three groups.ConclusionRemodeling of choroidal drainage routes by venous anastomosis between superior and inferior vortex veins may be common in CSC. The 3D-CVI could be a comprehensive parameter to evaluate the choroid vasculature and help understand the pathogenesis of pachychoroid spectrum disease.

Project description:PurposeTo detect and quantify choroidal neovascularization (CNV) in patients with age-related macular degeneration (AMD) using optical coherence tomography (OCT) angiography.DesignObservational, cross-sectional study.ParticipantsA total of 5 normal subjects and 5 subjects with neovascular AMD were included.MethodsA total of 5 eyes with neovascular AMD and 5 normal age-matched controls were scanned by a high-speed (100 000 A-scans/seconds) 1050-nm wavelength swept-source OCT. The macular angiography scan covered a 3 × 3-mm area and comprised 200 × 200 × 8 A-scans acquired in 3.5 seconds. Flow was detected using the split-spectrum amplitude-decorrelation angiography (SSADA) algorithm. Motion artifacts were removed by 3-dimensional (3D) orthogonal registration and merging of 4 scans. The 3D angiography was segmented into 3 layers: inner retina (to show retinal vasculature), outer retina (to identify CNV), and choroid. En face maximum projection was used to obtain 2-dimensional angiograms from the 3 layers. The CNV area and flow index were computed from the en face OCT angiogram of the outer retinal layer. Flow (decorrelation) and structural data were combined in composite color angiograms for both en face and cross-sectional views.Main outcome measuresThe CNV angiogram, CNV area, and CNV flow index.ResultsEn face OCT angiograms of CNV showed sizes and locations that were confirmed by fluorescein angiography (FA). Optical coherence tomography angiography provided more distinct vascular network patterns that were less obscured by subretinal hemorrhage. The en face angiograms also showed areas of reduced choroidal flow adjacent to the CNV in all cases and significantly reduced retinal flow in 1 case. Cross-sectional angiograms were used to visualize CNV location relative to the retinal pigment epithelium and Bruch's layer and classify type I and type II CNV. A feeder vessel could be identified in 1 case. Higher flow indexes were associated with larger CNV and type II CNV.ConclusionsOptical coherence tomography angiography provides depth-resolved information and detailed images of CNV in neovascular AMD. Quantitative information regarding CNV flow and area can be obtained. Further studies are needed to assess the role of quantitative OCT angiography in the evaluation and treatment of neovascular AMD.

Dataset Information

Optical Coherence Tomography Angiography for Diagnosis of Choroidal Neovascularization in Chronic Central Serous Chorioretinopathy after Photodynamic Therapy.

Publications

Optical Coherence Tomography Angiography for Diagnosis of Choroidal Neovascularization in Chronic Central Serous Chorioretinopathy after Photodynamic Therapy.

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