Optical coherence tomography angiography findings in fellow eyes of choroidal neovascularisation associated with central serous chorioretinopathy

2019 ◽  
pp. bjophthalmol-2018-313576 ◽  
Author(s):  
Spoorti Krishna Reddy Mandadi ◽  
Sumit Randhir Singh ◽  
Niroj Kumar Sahoo ◽  
Sai Bhakti Mishra ◽  
Riccardo Sacconi ◽  
...  

AimTo evaluate the optical coherence tomography angiography (OCTA) features of fellow eyes of patients with unilateral choroidal neovascularisation (CNV) associated with chronic central serous chorioretinopathy (CSCR).MethodsMedical records of patients with chronic CSCR who had undergone OCT angiography of both the eyes were reviewed. Patients with evidence of unilateral CNV detected by conventional imaging (OCT, fluorescein angiography and/or indocyanine green angiography) were included in the study. The OCT and OCTA characteristics of fellow eyes were analysed.ResultsForty patients (80 eyes—40 fellow eyes) with chronic CSCR with evidence of CNV in one eye were included. Mean age of the patients was 54.9±9.9 years and 82.5 % were males. Twenty-five (62.5%) fellow eyes had flat irregular pigment epithelial detachment on OCT, out of which 21 had internal hyper-reflectivity. A definite vascular network was picked up by OCTA in 9 of these 40 fellow eyes (22.5%) which was not detected on conventional imaging. In addition, two eyes had an ill-defined hyper-reflectivity, which could not be classified as a definite network at that point of time. The networks detected on OCTA in fellow eyes were mostly inactive, suggesting a subclinical neovascularisation.ConclusionOne-fourth of fellow eyes showed vascular network which could not be diagnosed on conventional imaging which highlights the importance of imaging both the eyes of chronic CSCR for early detection of CNV using OCTA. Further longitudinal studies are needed to assess the clinical course of such subclinical vascular networks in CSCR.

2020 ◽  
pp. 112067212095267
Author(s):  
Niroj Kumar Sahoo ◽  
Spoorti Krishna Reddy Mandadi ◽  
Sumit Randhir Singh ◽  
Riccardo Sacconi ◽  
Claudio Iovino ◽  
...  

Purpose: To report longitudinal changes in fellow eyes of chronic central serous chorioretinopathy (CSCR) associated choroidal neovascularization (CNV) using optical coherence tomography angiography (OCTA) and determine factors affecting neovascular conversion. Methods: Medical records of patients with chronic CSCR complicated by CNV and a minimum follow up of 6 months were reviewed. OCT and OCTA features were analyzed at baseline and final follow up. Baseline factors were assessed for predictive value against presence of CNV at follow up and conversion to exudative form. Results: Twenty-six subjects (26 CNV and 26 fellow eyes) were included in the study and followed up for a mean period of 26 ± 17 months. Nine eyes had CNV network in fellow eye at baseline, out of which three (33%) had a conversion to exudative CNV. Among the remaining 17 eyes, one eye developed a new network during a period of 44 months. An increase in the size of network was seen from 0.886 ± 0.945 mm2 at baseline to 1.326 ± 1.263 mm2 at follow up. Baseline choroidal thickness at sub-fovea was 345.4 ± 74.9 microns in eyes having network at last visit, compared to 440.1 ± 73.7 microns in eyes having no network.( p < 0.001) None of the baseline variables were found to be significantly associated with conversion to exudative form or presence of CNV on follow up in multivariate analysis. Conclusion: A conversion rate to exudative form was seen in 33% of fellow eyes with CNV. Relatively thinner choroid at baseline was associated with exudative conversion during follow up.


2020 ◽  
Author(s):  
Juejun Liu ◽  
Changzheng Chen ◽  
Lu Li ◽  
Yishuang Xu ◽  
Zuohuizi Yi ◽  
...  

Abstract Background: Optical coherence tomography angiography (OCTA) is a newly developed imaging quantitative technique for analysis of choriocapillaris (CC) flow changes, thereby exploring the pathological mechanism of chronic central serous chorioretinopathy (CCSC) and the therapeutic effects of photodynamic therapy (PDT). In this study, we sought to quantify the blood flow changes in CC of CCSC patients receiving half-dose PDT using OCTA.Methods: A total of 28 affected eyes and 24 unaffected eyes of 26 CCSC patients receiving half-dose PDT, and 40 eyes of 20 healthy gender- and age-matched subjects were retrospectively enrolled in this study. The proportion of total areas of flow signal voids (FSV, %) in CC level of OCTA was assessed in both eyes of the CCSC patients at baseline and repeated in multiple sections at 1-week, 1-month, 3-month and 6-month intervals after PDT. In addition, the CC patterns in response to PDT at early stage and the subsequent morphologic changes were qualitatively documented using OCTA.Results: For affected eyes, FSV at 6-m follow-up was significantly lower than that at 1-m follow-up (p=0.036). When compared to normal control eyes, FSV in affected eyes was significantly higher at 1-m, 3-m and 6-m follow-up (p<0.05 for all), and FSV in unaffected eyes was significantly higher at baseline, 1-w, 1-m and 3-m follow-up (p<0.05 for all). Three CC patterns of early response to PDT were identified, including signs of recovery with more even flow signals, transient appearance of worse ischemia and secondary neovascularization within CC level.Conclusion: Abnormal CC flow attenuation remains in completely resolved eyes of CCSC patients treated with half-dose PDT.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Juejun Liu ◽  
Changzheng Chen ◽  
Lu Li ◽  
Yishuang Xu ◽  
Zuohuizi Yi ◽  
...  

Abstract Background Optical coherence tomography angiography (OCTA) is a newly developed imaging quantitative technique for analysis of choriocapillaris (CC) flow changes, thereby exploring the pathological mechanism of chronic central serous chorioretinopathy (CCSC) and the therapeutic effects of photodynamic therapy (PDT). In this study, we sought to quantify the blood flow changes in CC of CCSC patients receiving half-dose PDT using OCTA. Methods A total of 28 affected eyes and 24 unaffected eyes of 26 CCSC patients receiving half-dose PDT, and 40 eyes of 20 healthy gender- and age-matched subjects were retrospectively enrolled in this study. The proportion of total areas of flow signal voids (FSV, %) in CC level of OCTA was assessed in both eyes of the CCSC patients at baseline and repeated in multiple sections at 1-week, 1-month, 3-month and 6-month intervals after PDT. In addition, the CC patterns in response to PDT at early stage and the subsequent morphologic changes were qualitatively documented using OCTA. Results For affected eyes, FSV at 6-m follow-up was significantly lower than that at 1-m follow-up (p = 0.036). When compared to normal control eyes, FSV in affected eyes was significantly higher at 1-m, 3-m and 6-m follow-up (p < 0.05 for all), and FSV in unaffected eyes was significantly higher at baseline, 1-w, 1-m and 3-m follow-up (p < 0.05 for all). Three CC patterns of early response to PDT were identified, including signs of recovery with more even flow signals, transient appearance of worse ischemia and secondary neovascularization within CC level. Conclusion Abnormal CC flow attenuation remains in completely resolved eyes of CCSC patients treated with half-dose PDT.


Author(s):  
Manuel A P Vilela

Chronic central serous chorioretinopathy (cCSC) can produce an overlap of signs that can be difficult to distinguish from cases with non-exudative neovascular age-related macular degeneration (nneAMD). Around 2-10% of the patients with cCSC will develop neovascularization. Sometimes both diseases could be present at the same individual. The purpose of this narrative review is to discuss the current information concerning the signs in OCT angiography that eventually could help to differentiate these situations and analyze the best diagnostic evidence.  


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Georges Azar ◽  
Catherine Favard ◽  
Sawsen Salah ◽  
Antoine Brézin ◽  
Vivien Vasseur ◽  
...  

Purpose. To highlight the advantages of optical coherence tomography angiography (OCTA) in delineating the morphological features of the retinal and choroidal vascular network during acute, relapsing, and quiescent stages of macular toxoplasma retinochoroiditis. Methods. This prospective study included patients presenting with both active and quiescent ocular toxoplasmoses. OCTA was obtained to diagnose and follow the subsequent vascular network changes at diagnosis and six months after acute presentation. Results. Twenty-three eyes of 23 patients were included. In active lesions, OCTA showed extensive, well-delineated areas of intense hyposignal and perifoveal capillary arcade disruption in the parafoveal superficial capillary plexus (pSCP) and less extensive hyposignal in the parafoveal deep capillary plexus (pDCP). Signals of decreased deep capillary density and disorganization were also seen in the choroid. In nonactive lesions, OCTA demonstrated a homogenous and equally attenuated grayish hyposignal of the pSCP and pDCP and a partial restoration of the nonperfused choroidal areas. Conclusion. OCTA is a useful technique for vascular network analysis in toxoplasma retinochoroiditis. It allows the visualization of the different network changes and behaviors during the different stages of the infection.


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