Correlation between redefined optical coherence tomography parameters and best-corrected visual acuity in non-resolving central serous chorioretinopathy treated with half-dose photodynamic therapy

Aim. Develop a methodology and evaluate the clinical results of laser treatment of patients with chronic central serous chorioretinopathy in the presence of a leakage point in the foveola zone. Methods. The results of patients (32 eyes) with central serous chorioretinopathy after laser exposure in the avascular area were analyzed. The best-corrected visual acuity in these patients before treatment was 0.7 to 1.0 (average 0.78±0.15) with a height of neuroepithelial detachment of 162 to 328 μm according to optical coherence tomography. No signs of choroidal neovascularization was detected in angio mode on optical coherence tomography. The treatment was performed with an Ellex Integre Pro Scan 561 nm. The follow-up examination was performed in 1 and 6 months. Results. In 1 month, positive dynamics of both functional and anatomical parameters was noted in all eyes. According to the optical coherence tomography, a complete attachment of the neuroepithelium in the central zone of the retina occurred, detachment of the neuroepithelium was absent. Best-corrected visual acuity in 1 month after treatment increased to 0.89±0.08, in 6 months to 0.92±0.04. The study revealed a correlation between visual acuity and the central thickness of the retina in the fovea, there were no complaints about the appearance of scotomas after laser treatment in the foveola zone. Conclusion. The developed techniqe of laser exposure on the foveola zone in case of chronic central serous chorioretinopathy with a 561 nm laser demonstrated high clinical efficacy and safety and can be recommended to all patients with central serous chorioretinopathy.

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Foveal Exudative Macroaneurysm Treated with Intravitreal Ranibizumab

Case Reports in Ophthalmology ◽

10.1159/000431353 ◽

2015 ◽

Vol 6 (2) ◽

pp. 170-175 ◽

Cited By ~ 6

Author(s):

Carlos Menezes ◽

Rui Carvalho ◽

Carla Teixeira ◽

José Alberto Lemos ◽

Rita Gonçalves ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Macular Edema ◽

Morphological Data ◽

Foveal Avascular Zone ◽

Optical Coherence ◽

Intravitreal Ranibizumab ◽

Corrected Visual Acuity ◽

Retinal Macroaneurysm ◽

Best Corrected Visual Acuity

Purpose: We report a case of a foveal macroaneurysm with long-standing macular edema in a rare location, successfully treated with intravitreal ranibizumab. Methods: We report the case of a 52-year-old man with left eye long-term visual loss due to macular edema caused by a retinal macroaneurysm, localized about 400 μm from the center of the fovea, and its response to 6 monthly ranibizumab intravitreal injections. His best-corrected visual acuity and morphological data evaluated by optical coherence tomography and fluorescein angiography are presented. Results: His best-corrected visual acuity improved from 1/10 to 3/10 after the 3rd injection, and from 1/10 to 4/10 after the 6th one. The central retinal thickness was evaluated by optical coherence tomography and improved from 310 to 233 μm, with the resolution of both the associated serous detachments and the cystoid macular edema; an almost complete reabsorption of the hard exudates at the end of the treatment was also observed. The macroaneurysm lumen almost obliterated after the 3rd injection and completely collapsed at the end of treatment. Conclusions: Intravitreal ranibizumab may be effective in the treatment of long-standing macular edema associated with foveal macroaneurysms. To the best of our knowledge, this is the first report of a retinal macroaneurysm located so close to the foveal avascular zone.

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Assessment of choriocapillary blood flow changes in response to half-dose photodynamic therapy in chronic central serous chorioretinopathy using optical coherence tomography angiography

10.21203/rs.2.18778/v6 ◽

2020 ◽

Author(s):

Juejun Liu ◽

Changzheng Chen ◽

Lu Li ◽

Yishuang Xu ◽

Zuohuizi Yi ◽

...

Keyword(s):

Blood Flow ◽

Optical Coherence Tomography ◽

Photodynamic Therapy ◽

Central Serous Chorioretinopathy ◽

Optical Coherence Tomography Angiography ◽

Optical Coherence ◽

Chronic Central Serous Chorioretinopathy ◽

Half Dose ◽

Flow Changes

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.

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Assessment of choriocapillary blood flow changes in response to half-dose photodynamic therapy in chronic central serous chorioretinopathy using optical coherence tomography angiography

BMC Ophthalmology ◽

10.1186/s12886-020-01674-9 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Juejun Liu ◽

Changzheng Chen ◽

Lu Li ◽

Yishuang Xu ◽

Zuohuizi Yi ◽

...

Keyword(s):

Blood Flow ◽

Optical Coherence Tomography ◽

Photodynamic Therapy ◽

Central Serous Chorioretinopathy ◽

Optical Coherence Tomography Angiography ◽

Optical Coherence ◽

Chronic Central Serous Chorioretinopathy ◽

Half Dose ◽

Flow Changes

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.

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Optic coherence tomography angiography follow-up in a case of Purtscher-like retinopathy due to atypical hemolytic uremic syndrome

European Journal of Ophthalmology ◽

10.1177/1120672119833277 ◽

2019 ◽

Vol 30 (3) ◽

pp. NP14-NP17 ◽

Cited By ~ 1

Author(s):

Juan Francisco Santamaría Álvarez ◽

Anna Serret Camps ◽

Javier Aguayo Alvarez ◽

Olga García García

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Hemolytic Uremic Syndrome ◽

Optical Coherence Tomography Angiography ◽

Atypical Hemolytic Uremic Syndrome ◽

Optical Coherence ◽

Corrected Visual Acuity ◽

Capillary Plexus ◽

Uremic Syndrome ◽

Best Corrected Visual Acuity

Purpose: To report a case of Purtscher-like retinopathy due to atypical hemolytic uremic syndrome and the changes seen in the optical coherence tomography angiography before and after treatment with eculizumab. Case description: A 22-year-old man with an unremarkable medical history presented with acute, bilateral blurred vision and headache of 1-week duration. Best corrected visual acuity of 20/50 and 20/40, respectively, in the patient’s right eye and left eye. Funduscopy revealed multiple cotton-wool spots associated with intrarretinal fluid. Swept source optical coherence tomography revealed multifocal retinal detachments with increased choroidal thickness. Optical coherence tomography angiography showed areas of ischemia in both capillary plexus. Due to concurrent symptoms and laboratory analysis, he was diagnosed with atypical hemolytic uremic syndrome and secondary Purtscher-like retinopathy; therefore, treatment with eculizumab was initiated. After 2 months revascularization of the previous ischemic areas was seen in the optical coherence tomography angiography that were correlated with best corrected visual acuity improvement. Conclusion: Our findings suggest that evaluation of the macular capillary plexus revascularization by optical coherence tomography angiography during the disease could help to predict an improvement of best corrected visual acuity in these patients and the measurement of choroidal thickness could give us information about the resolution of the pathologic process.

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Intravitreal aflibercept efficacy in neovascular age-related macular degeneration with suboptimal response to anti-vascular endothelial growth factor-A therapy

European Journal of Ophthalmology ◽

10.1177/1120672119848961 ◽

2019 ◽

Vol 30 (5) ◽

pp. 1082-1090

Author(s):

Jordi Monés ◽

Marc Biarnés ◽

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Macular Degeneration ◽

Subretinal Fluid ◽

Age Related Macular Degeneration ◽

Optical Coherence ◽

Corrected Visual Acuity ◽

Age Related ◽

Endothelial Growth Factor ◽

Best Corrected Visual Acuity

Importance: To provide new insights into aflibercept effect in non-naive-treated patients with neovascular age-related macular degeneration. Purpose: To assess the efficacy of intravitreal aflibercept in patients with neovascular age-related macular degeneration without optimal response to previous anti-vascular endothelial growth factor A therapy. Design: Single-arm, multi-centre, prospective study. Participants: Patients ⩾50 years with active neovascular age-related macular degeneration, best-corrected visual acuity between 20/32 and 20/320 with suboptimal response to ranibizumab or bevacizumab. Methods: Aflibercept was administered monthly (3-first months), and bimonthly thereafter until month 8. Anatomical and functional outcomes were assessed. Main outcome measure: Percentage of eyes without intra or subretinal fluid on optical coherence tomography after 3-monthly loading doses of aflibercept. Results: A total of 46 patients were included. At week 12, 45.7% (95% confidence interval: 31.5%–60.1%) of eyes showed no fluid on optical coherence tomography. The mean (standard deviation) best-corrected visual acuity increased from 65.1 (8.3) to 69.6 (8.1) letters (+4.5 (5.8) p < 0.0001) and was stabilized at week 40 as compared to baseline. Mean central macular thickness decreased from 430 (119) µm to 323 (100) µm at week 12 (–107 (90) µm, p < 0.0001) and was reduced at week 40 (–46 (111) µm, p = 0.0056). At week 40, 21.7% (95% confidence interval: 9.8%–33.7%) had no fluid. There was a case of presumed noninfectious endophthalmitis that was successfully managed. Conclusion: Almost half of patients presented no fluid on optical coherence tomography at week 12, and there was a clinically significant improvement in best-corrected visual acuity. At week 40, one in five patients did not show intra or subretinal fluid, central macular thickness decreased and best-corrected visual acuity was stabilized compared to baseline.

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