Dark and white lesions observed in central serous chorioretinopathy on optical coherence tomography angiography

2018 ◽  
Vol 28 (4) ◽  
pp. 446-453 ◽  
Author(s):  
Flore De Bats ◽  
Pierre-Loïc Cornut ◽  
Benjamin Wolff ◽  
Laurent Kodjikian ◽  
Martine Mauget-Faÿsse
Keyword(s):  
Optical Coherence Tomography ◽  
Central Serous Chorioretinopathy ◽  
Multimodal Imaging ◽  
Optical Coherence Tomography Angiography ◽  
Pigment Epithelium ◽  
Serous Retinal Detachment ◽  
Descriptive Study ◽  
Dark Spot ◽  
Optical Coherence ◽  
Choroidal Neovascular Membrane

Purpose: To describe abnormal dark (hyposignal) and white (hypersignal) lesions observed on optical coherence tomography angiography in central serous chorioretinopathy. Methods: Prospective, multicenter, and descriptive study including patients with active or quiescent central serous chorioretinopathy. All patients had undergone a complete ophthalmic examination. Results: Abnormal dark lesions were detected as “dark spots” and “dark areas” on optical coherence tomography angiography. A “dark spot” could correspond to six different abnormalities: pigment epithelium detachment, subretinal deposit, “Lucency” within surrounding subretinal fibrin, choroidal cavitation, choroidal excavation, and choroidal fluid. A “dark area” could be related to a serous retinal detachment or choriocapillary compression. Abnormal white lesions were also detected: A “white spot” could correspond with the leaking point on fluorescein angiography or with hyper-reflective dots; A “white filamentous pattern” at the Brüch’s membrane level corresponded to abnormal choroidal neovascular vessels. Conclusion: A semiology is described using optical coherence tomography angiography in central serous chorioretinopathy as abnormal dark and white lesions. Multimodal imaging is mandatory in addition to optical coherence tomography angiography to diagnose non-neovascular retinal and choroidal central serous chorioretinopathy lesions. However, optical coherence tomography angiography alone is helpful in detecting choroidal neovascular membrane in central serous chorioretinopathy.

scholarly journals Optical Coherence Tomography Angiography in Central Serous Chorioretinopathy

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Eliana Costanzo ◽  
Salomon Yves Cohen ◽  
Alexandra Miere ◽  
Giuseppe Querques ◽  
Vittorio Capuano ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Choroidal Neovascularization ◽  
Central Serous Chorioretinopathy ◽  
Multimodal Imaging ◽  
Optical Coherence Tomography Angiography ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Serous Retinal Detachment ◽  
Optical Coherence ◽  
Outer Retina

Purpose. To analyze optical coherence tomography angiography (OCTA) findings in eyes with central serous chorioretinopathy (CSC) and to compare them with those obtained with multimodal imaging.Methods. A series of consecutive patients diagnosed with CSC, underwent OCTA and multimodal imaging, including spectral domain OCT, fluorescein, and indocyanine green angiography. OCTA images were performed at three main depth intervals: automatically segmented outer retina, manually adjusted outer retina, and automatically segmented choriocapillaris.Results. Thirty-three eyes of 32 consecutive patients were analyzed. OCTA showed 3 main anomalies at the choriocapillaris: the presence of dark areas (19/33 eyes) which were frequently associated with serous retinal detachment, presence of dark spots (7/33 eyes) which were frequently associated with retinal pigment epithelium detachment, and presence of abnormal vessels (12/33 eyes) which were frequently, but not systematically, associated with choroidal neovascularization, as confirmed by multimodal imaging.Conclusions. OCTA revealed dark areas and dark spots, which were commonly observed. An abnormal choroidal pattern was also observed in one-third of cases, even when multimodal imaging did not evidence any choroidal neovascularization. Abnormal choroidal vessels should be interpreted with caution, and we could assume that this pathological choroidal vascular pattern observed in many CSC cases could be distinct from CNV.

Multimodal imaging evaluation of combined hamartoma of the retina and retinal pigment epithelium

2019 ◽  
Vol 30 (3) ◽  
pp. 595-599 ◽  
Author(s):  
Andrea Scupola ◽  
Gabriela Grimaldi ◽  
Maria G Sammarco ◽  
Paola Sasso ◽  
Michele Marullo ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Retinal Pigment Epithelium ◽  
Multimodal Imaging ◽  
Optical Coherence Tomography Angiography ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Case Series ◽  
Variable Degree ◽  
Optical Coherence ◽  
Imaging Evaluation

Purpose: Combined hamartoma of the retina and retinal pigment epithelium is a rare benign tumor characterized by a variable combination of glial, vascular, and pigmented components. The purpose of our study was to analyze the features of combined hamartoma of the retina and retinal pigment epithelium on optical coherence tomography angiography. Methods: Small case series of two cases of combined hamartoma of the retina and retinal pigment epithelium with macular and optic nerve involvement, evaluated with multimodal imaging including optical coherence tomography, fluorescein angiography, and optical coherence tomography angiography. Results: On optical coherence tomography, combined hamartoma of the retina and retinal pigment epithelium is characterized by disruption of the inner neurosensory retina and a variable degree of involvement of the external retina. Optical coherence tomography angiography showed diffuse alterations of the retinal vessels of the superficial and deeper layers, extended to the peripapillary area. Vessel abnormalities included increased tortuosity and caliber of vessels, vascular traction, and vessel stretching within the lesion. Conclusion: Optical coherence tomography angiography allows in-depth multilayer analysis of tumor vascular network, highlighting the fine abnormalities of retinal vasculature characteristic of combined hamartoma of the retina and retinal pigment epithelium.

Optical Coherence Tomography Angiography Findings in Laser Maculopathy

2017 ◽  
Vol 27 (1) ◽  
pp. 13-15 ◽  
Author(s):  
Livia Tomasso ◽  
Lucia Benatti ◽  
Carlo La Spina ◽  
Rosangela Lattanzio ◽  
Giovanni Baldin ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Multimodal Imaging ◽  
Thermal Injury ◽  
Optical Coherence Tomography Angiography ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Plexiform Layer ◽  
Optical Coherence ◽  
Laser Pointer ◽  
Laser Injury

Purpose Handheld laser pointer thermal injury affects primarily the retinal pigment epithelium (RPE). However, so far no study has reported on the possible effects of laser pointers in the deeper layers, beneath the RPE. Here, we describe the spectral-domain optical coherence tomography angiography findings in the choriocapillaris of a patient with laser maculopathy. Methods A 13-year-old boy presented to our department with decreased vision in the left eye 12 hours after having stared at the beam of a laser pointer. Results Structural optical coherence tomography (OCT) showed 2 focal hyperreflective columns at the fovea extending from the RPE, involving all outer retinal layers, and terminating at the outer plexiform layer. The patient also underwent OCT angiography (OCT-A), which in the choriocapillary segmentation revealed 2 hypointense lesions in correspondence of the focal hyperreflectivities detected on structural OCT. We hypothesize that the OCT-A findings could represent a rarefaction of the choriocapillaris. However, the choriocapillary OCT-A findings could also represent artifacts due to the overlaying hyperreflective lesions. Conclusions It is known that the RPE is primarily damaged by the laser injury. Our findings suggest that the thermal injury could involve also the choriocapillaris, and thus not limited to the RPE. Multimodal imaging in laser maculopathy including OCT-A may lead to a better comprehension of the pathogenesis of laser retinal damages.

scholarly journals Choroidal Vascular Changes in Acute Idiopathic Maculopathy as Demonstrated by Multimodal Imaging including Optical Coherence Tomography Angiography

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Tahsin Khundkar ◽  
Syed R. Hasan ◽  
Mark P. Breazzano ◽  
Constance Mei ◽  
Brandon B. Johnson
Keyword(s):  
Optical Coherence Tomography ◽  
Multimodal Imaging ◽  
Optical Coherence Tomography Angiography ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Optical Coherence ◽  
Vascular Changes ◽  
Paracentral Scotoma ◽  
The Right ◽  
Choroidal Perfusion

Purpose. To present a case of acute idiopathic maculopathy (AIM) and illustrate primary choroidal perfusion defect using multimodal imaging. Case Description. We report a case of a 24-year-old man with a paracentral scotoma of the right eye and recent flu-like illness. The patient was found to have a unilateral ovoid-shaped, placoid lesion just inferior to the fovea. Multimodal imaging confirmed findings most consistent with a diagnosis of acute idiopathic maculopathy (AIM). Serologic studies confirmed a strongly positive immunoglobulin G (IgG) titer for coxsackievirus A. Spectral-domain optical coherence tomography angiography (SD-OCTA) showed bilateral areas of vascular reduction at the level of the choriocapillaris and choroid, sparing the retinal circulation. Conclusions and Importance. The changes in outer retina and retinal pigment epithelium, classically described in AIM, are likely secondary to choroidal hypoperfusion.

scholarly journals Accordance of Indocyanine Green Angiography and Optical Coherence Tomography Angiography in Visualization of Neovascularization Associated with Chronic Central Serous Chorioretinopathy

2018 ◽  
Vol 15 (2S) ◽  
pp. 254-260
Author(s):  
E. K. Pedanova ◽  
O. B. Klepinina ◽  
D. A. Buryakov
Keyword(s):  
Optical Coherence Tomography ◽  
Indocyanine Green ◽  
Central Serous Chorioretinopathy ◽  
Indocyanine Green Angiography ◽  
Optical Coherence Tomography Angiography ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Diagnostic Methods ◽  
Optical Coherence ◽  
Chronic Central Serous Chorioretinopathy

Purpose: to compare informativity and accordance of indocyanine green angiography (ICGA) and optical coherence tomography angiography (OCT-A) data in visualization of neovascularization associated with chronic central serous chorioretinopathy. Patients andMethods. Twenty one eye of 21 patients (aged 51.0 ± 8.4 years old) with chronic central serous chorioretinopathy (CSR) and assumed choroidal neovascularisation (CNV) with «double layer» sign on optical coherence tomography scans were enrolled in this study. ICGA on Spectralis HRA+OCT, (Heidelberg Engeneering, Germany) and OCT-A on RTVue XR Avanti (Optovue, USA) were performed to evaluate CNV. The assessment of obtained pictures was examined by two experts.Results. Both diagnostic methods have shown similar results. CNV has been revealed in 11 of 21 eyes by ICGA imaging while OCT-A confirmed neovascularization in 13 eyes — with no statistical difference between methods (p = 0.74, χ2). CNV has not been diagnosed in 10 cases by ICGA and in 8 cases by OCT-A (p = 0.69). However, the consistency of the two methods in CNV evaluation while pairwise comparison of angiography data has been confirmed only in 8 eyes. The absence of CNV has been confirmed in 6 eyes — mostly in patients with CSR recurrence. One third of patients (7 of 21 eyes) have not shown consistence of two methods. The OCT-A visualization of CNV could be poor because of subretinal deposits and pigment-related signal blocking. In cases of diffuse retinal pigment epithelium atrophy the neovascular network cannot been seen on ICGA images while well visualized on OCT-A.Conclusion. The informativity of ICGA and OCT-A in visualization of neovascularization associated with chronic central serous chorioretinopathy is similar. For the best data interpretation the condition of neurosensory retina and pigment retinal epitheluium should be taken into account. OCT-A is more preferable in cases of diffuse epitheliopathy, while the neovascularization activity and leakage points is better seen on ICGA. 

scholarly journals Applications of Multimodal Imaging in Central Serous Chorioretinopathy Evaluation

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Mary Ho ◽  
Gabriel Li ◽  
Andrew Mak ◽  
Danny Ng ◽  
Lawrence Iu ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Central Serous Chorioretinopathy ◽  
Multimodal Imaging ◽  
Wide Spectrum ◽  
Imaging Techniques ◽  
Fundus Autofluorescence ◽  
Serous Retinal Detachment ◽  
Significant Proportion ◽  
Wide Field ◽  
Optical Coherence

Central serous chorioretinopathy (CSCR) is a macular disease characterized by serous retinal detachment commonly involving the macular region. CSCR has a wide spectrum of clinical presentations. Although a significant proportion of CSCR cases are self-limiting, patients can suffer from persistent or recurrent disease, sometimes complicated with choroidal neovascularization, resulting in permanent visual loss. Multimodal imaging, including fluorescein angiography, indocyanine green angiography, fundus autofluorescence, and optical coherence tomography, has advanced the diagnosis and classification of CSCR cases. Evolution of new imaging techniques including optical coherence tomography angiography, wide-field imaging, and en face reconstruction imaging has also contributed to better understandings of the pathophysiology of CSCR. This review article summarizes the features of multimodal imaging for CSCR and discusses the application of such features in evaluating the disease.

scholarly journals Choriocapillaris Island: an optical coherence tomography angiography finding observed in central serous chorioretinopathy

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Rania G. Estawro ◽  
Alaa E. Fayed ◽  
Teresa K. Gerges ◽  
Dina N. Baddar
Keyword(s):  
Optical Coherence Tomography ◽  
Central Serous Chorioretinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Optical Coherence ◽  
Fundus Fluorescein Angiography ◽  
Density Maps ◽  
En Face

Abstract Purpose To report the observation of the choriocapillaris island (CCI) on optical coherence tomography angiography (OCTA) in eyes with active central serous chorioretinopathy (CSCR), and to investigate its associated clinical features. Design Retrospective observational study. Methods Patients diagnosed with active CSCR underwent OCTA imaging (Optovue Inc, Fremont, California, USA), and the software built-in en face choriocapillaris slab was examined to demonstrate CCI, defined as an area of detectable choriocapillaris flow surrounded by an area of undetectable or diminished flow. Electronic medical records (EMR) were reviewed for demographics, clinical data, other imaging modalities and any intervention, and these parameters were correlated with CCI findings. Results 25 eyes of 25 patients were recruited. CCI was detected in all examined eyes and was best elucidated on the en face choriocapillaris density maps. 24 eyes had focal retinal pigment epithelium (RPE) alterations overlying CCI. All 14 eyes with simultaneous fundus fluorescein angiography (FA) showed actively leaking point(s) well corresponding to the CCI location. Resolution of sub-retinal fluid in 4 eyes was associated with disappearance of CCI on follow-up OCTA scans. 1 eye showed complicating neovascularization 5 months after the initial presentation at the same location of the CCI. Conclusion We demonstrate the observation of the “choriocapillaris island” an OCTA finding in eyes with active CSCR underneath the area of neurosensory detachment. CCI may constitute an angiographic representation of the focal area of choriocapillaris structural and functional affection, with secondary RPE alteration jeopardizing its barrier function. Larger longitudinal studies are needed to further elucidate this finding.

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