Swept-Source Optical Coherence Tomography Angiography in Central Serous Chorioretinopathy

2018 ◽  
Vol 2 (6) ◽  
pp. 351-357
Author(s):  
Zofia Michalewska ◽  
Jerzy Nawrocki

Purpose: This article aims to evaluate the appearance of central serous chorioretinopathy (CSC) with swept-source optical coherence tomography angiography (SS-OCTA), to discuss whether localization of the leakage spot seen on fluorescein angiography (FA) corresponds to any recognizable spot on SS-OCTA, and to provide subsequent diagnosis of choroidal neovascularization (CNV) in the course of CSC. Methods: A prospective interventional case series was conducted in a private outpatient office on 30 eyes of 27 patients. In addition to ophthalmic examination, FA, spectral-domain OCT, SS-OCT and SS-OCTA were performed at least once. If laser photocoagulation or anti-vascular endothelial growth factor (anti-VEGF) injection was administered, then all examinations were repeated afterward. Following SS-OCTA, morphology features of CSC were analyzed: localization of the leakage spot, presence of feeder vessels, and presence of CNV. Changes after treatment were recorded. Results: In 26 of 30 cases the leakage site on FA corresponded to a highly hyporeflective site on SS-OCTA. In 7 of these cases laser was successfully administered. In 20/30 eyes we additionally observed thickened vessels at the level of choriocapillaris in close proximity to the most hyporeflective spot. CNV was observed in 4 cases. The leakage spot is the most hyporeflective spot on SS-OCTA localized at the level of choriocapillaris. Additionally, choroidal feeder vessels might be visualized at the level of choriocapillaris in 66% of cases. In 4 eyes, CNV in the course of CSC was noted. Conclusions: In CSC, SS-OCTA is a valuable diagnostic tool and its results complement FA. It might add to the treatment process, especially regarding the need to start and to monitor anti-VEGF injections. Anti-VEGF treatment results in fading but not in complete disappearance of CNV in the course of CSC.

2021 ◽  
pp. 112067212098636
Author(s):  
Katarzyna Chwiejczak ◽  
Susmito Biswas ◽  
Emmanouil Tsamis ◽  
Irene Siso-Fuertes ◽  
Shakti Kasbia ◽  
...  

Purpose: To analyze if Segmented Swept-Source Optical Coherence Tomography Angiography (SS OCT-A) can provide additional information on morphology and pathophysiology of macular fibrosis in Coats’ patients. Methods: A consecutive case series of three male patients (5, 7 and 15 years old), with Coats’ disease-related macular fibrosis (stage 2b-2 patients, 3b-1 patient). SS OCT-A 3×3 mm macular scans of affected eyes were performed. Results: In all three cases the inner portion of macular fibrosis displayed a dense network of vessels, continuing into deeper layers. This structure was similar to that observed in retinal angiomatous proliferations (RAP). There was associated loss of the foveal avascular zone. In one case we observed evolution of the lesion. Conclusion: SS-OCT imaging of macular fibrosis in Coats’ disease reveals a distinct intralesional vascular structure with elements resembling RAP, probably developing as a secondary process.


2017 ◽  
Vol 27 (2) ◽  
pp. e35-e38 ◽  
Author(s):  
Claudia Del Turco ◽  
Alessandro Rabiolo ◽  
Adriano Carnevali ◽  
Carlo La Spina ◽  
Paolo Bettin ◽  
...  

Purpose To report 3 cases of ocular chorioretinal folds from different etiologies and their aspect with the new imaging technology of optical coherence tomography (OCT) angiography (OCT-A). Methods Baseline data, investigational process on etiology, and follow-up data of patients referred for chorioretinal folds to the Medical Retina & Imaging Unit of San Raffaele Hospital in the period January-March 2016 were collected. Multimodal imaging evaluation, comprehensive of infrared, fundus autofluorescence, multicolor, spectral-domain OCT, and OCT-A, was performed on all patients. Results Four eyes of 3 men, 65, 46, and 50 years of age, showed chorioretinal folds secondary to central serous chorioretinopathy, postoperative hypotony (after deep sclerectomy), and anisometropia with unilateral hyperopia, respectively. In all cases, OCT-A imaging showed a signal reduction in the choriocapillaris layer in correspondence of the folds. Due to this signal reduction, the en face reconstruction of choriocapillaris layer showed, in all cases, a peculiar tigroid aspect. The aspect of the folds at OCT-A remained unchanged during the 3-month follow-up in all patients. Conclusions Optical coherence tomography angiography shows a typical linear signal reduction in the choriocapillaris layer in correspondence of the fold with a tigroid pattern. We hypothesize this aspect could be explained by blood flow alteration at the choriocapillaris level in correspondence of the fold.


2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Martin Stattin ◽  
Julia Forster ◽  
Ahmed Daniel ◽  
Alexandra Graf ◽  
Katharina Krepler ◽  
...  

Purpose. To assess the relationship between signs of activity in exudative neovascular age-related macular degeneration (nAMD) following anti-vascular endothelial growth factor (anti-VEGF) treatment and morphology of choroidal neovascularization (CNV) based on neovascular density as imaged using swept source-optical coherence tomography angiography (SS-OCTA) in a qualitative manner. Methods. A single-cohort retrospective data analysis from one tertiary eye care center. Seventy-seven eyes of 72 patients were included and their charts reviewed which had been started on intravitreal injections with anti-VEGF for nAMD at least one year prior to enrollment. Clinically active disease was evaluated by slit-lamp fundus examination and spectral domain-OCT B-scans. Morphological appearance in SS-OCTA was characterized based on 5 different criteria and subsequently divided into 3 groups: predominantly hyperdense, minimally hyperdense, and hypodense lesions. Results. Fifty-eight eyes (75%) were considered clinically active and 19 eyes (25%) clinically inactive. CNV was depicted in 71 eyes (92%) by SS-OCTA and separated accordingly into predominantly hyperdense (32%), minimally hyperdense (34%), and hypodense lesions (34%). A borderline significant difference in the probability of neovascular activity for predominantly hyperdense lesions compared to hypodense lesions was detected (p=0.05). Conclusions. Hyperdense choroidal neovascularization based on qualitative assessment of flow density showed a significant relation to active disease. Inactivity could not be matched adequately. This study demonstrated the potential usefulness of SS-OCTA for guidance of treatment in age-related macular degeneration.


2019 ◽  
Author(s):  
Jingli Guo ◽  
Xinyi Ding ◽  
Yongjin Zhang ◽  
Gezhi Xu ◽  
Haixiang Wu

Abstract Background To compare the vascular changes of superficial capillary layer (SCP) and deep capillary layer (DCP) in retina and choriocapillary layer in eyes with acute central serous chorioretinopathy (CSCR) by optical coherence tomography angiography (OCTA) between at baseline and 3 months. Methods Prospective case series; Twelve patients (12 eyes) with acute CSCR at the baseline and 3 months were included. All patients underwent comprehensive ophthalmic examinations. Subfoveal choroidal thickness (SFCT) and central macular thickness (CMT) were evaluated by swept domain optical coherence tomography (SD-OCT). The foveal avascular zone (FAZ), the microvascular morphology and density of SCP and DCP, and the choroicapillary morphology were assessed by OCTA and Image J software. Results The mean CMT (p=0.018), the mean SFCT (p=0.013), the mean microvascular density of DCP (p<0.001) and choroicapillary layer (p<0.001) at baseline were different from the ones at 3 months. The density of DCP was increased and the areas of choriocapillaris flow signal void was shrinked at 3months in the process of self-resolve. Two eyes exhibited flat pigment epithelial detachment by OCT and OCTA demonstrated the formation of vascular in choroicapillary layer at 3 months. The en-face OCT can illstrate the area of ellipsoid zone (EZ) disruption. Conclusions OCTA enables the visualization of microvascular features of the DCP and choroidcapillary in eyes with acute CSCR in the process of self-resovle to help elucidate the pathophysiology. Flat pigment epithelial detachment presented by OCT in acute CSCR eyes can be revealed vascular structure in choroicapillary layer by OCTA. OCTA imaging seems to be a useful tool in the identification of acute CSCR.


2019 ◽  
Author(s):  
Jingli Guo ◽  
Xinyi Ding ◽  
Yongjin Zhang ◽  
Gezhi Xu ◽  
Haixiang Wu

Abstract Background To compare the vascular changes of superficial capillary layer (SCP) and deep capillary layer (DCP) in retina and choriocapillary layer in eyes with acute central serous chorioretinopathy (CSC) by optical coherence tomography angiography (OCTA) between at baseline and 3 months. Methods Prospective case series; Twelve patients (12 eyes) with acute CSC at the baseline and 3 months were included. All patients underwent comprehensive ophthalmic examinations. Subfoveal choroidal thickness (SFCT) and central macular thickness (CMT) were evaluated by spectral domain optical coherence tomography (SD-OCT). The foveal avascular zone (FAZ), the microvascular morphology and density of SCP and DCP, and the choroicapillary morphology were assessed by OCTA or Image J software. All data in this study were presented as mean and standard deviations (SD) Results The mean±SD CMT (p=0.018), the mean±SD SFCT (p=0.013), the mean±SD microvascular density of DCP (p<0.001) and choroicapillary layer (p<0.001) at baseline were different from the ones at 3 months. The density of DCP was increased and choriocapillaris flow signal void was recovered at 3months in the process of self-resolve. Two eyes exhibited vascularized flat pigment epithelial detachment (FIPED) by OCTA. The en-face OCT can illstrate the area of the elongation of ellipsoid zone (EZ). Conclusions OCTA enables the visualization of microvascular features of the DCP and choroidcapillary in eyes with acute CSC in the process of self-resovle to help elucidate the pathophysiology. Vascularized FIPED could be obtained in acute CSC eyes by OCTA. OCTA imaging seems to be a useful tool in the identification of acute CSC.


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