scholarly journals Short-term effect of anti-VEGF for chronic central serous chorioretinopathy according to the presence of choroidal neovascularization using optical coherence tomography angiography

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245342
Author(s):  
Yong-Yeon Song ◽  
Hwa-Young Yu ◽  
Seung-Kook Baek ◽  
Young-Hoon Lee ◽  
Min-Woo Lee

Purpose To analyze the short-term therapeutic efficacy of intravitreal injection of bevacizumab (IVB) for chronic central serous chorioretinopathy (CSC) according to the presence of choroidal neovascularization (CNV) using optical coherence tomography angiography (OCTA). Methods A retrospective chart review was perfomed on cases of CSC with CNV (Group 1: n = 31) and an age-matched cases of CSC without CNV (Group 2: n = 30). The response to IVB was evaluated by changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), choroidal thickness (CT), and pachyvessel diameter. Univariate and multivariate linear regression analyses were performed to identify factors associated with the visual outcome of chronic CSC with CNV after IVB. Results At baseline, the CT values differed significantly between Groups 1 and 2 (371.55 ± 67.09 vs. 417.33 ± 71.32 μm, p = 0.01). In Group 1, BCVA improved significantly (p < 0.001), and CMT (p < 0.001), CT (p = 0.001) and pachyvessel diameter (p = 0.045) decreased significantly, after IVB. In Group 2, only pachyvessel diameter (p = 0.001) was significantly smaller after IVB. Univariate analysis showed that the initial CT (B = 0.002, p = 0.026) and pachyvessel diameter (B = 0.002, p = 0.001) significantly affected visual outcome. In multivariate analysis, the initial pachyvessel diameter exhibited significant results (B = 0.002, p = 0.001). Conclusions IVB showed less effective short-term outcomes in chronic CSC patients without CNV than in patients with CNV. In chronic CSC with CNV, the short-term visual outcome after IVB was better in patients with a thinner choroid and smaller pachyvessels.

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Joanna Gołębiewska ◽  
Joanna Brydak-Godowska ◽  
Joanna Moneta-Wielgoś ◽  
Monika Turczyńska ◽  
Dariusz Kęcik ◽  
...  

Purpose. To assess the occurrence of choroidal neovascularization (CNV) secondary to chronic central serous chorioretinopathy (CSCR) using optical coherence tomography angiography (OCTA) and correlate these findings with choroidal thickness (CT). Materials and Methods. This retrospective study included 25 consecutive patients (43 eyes), mean age 48.12 ± 7.8 years, diagnosed with persistent CSCR. All patients underwent a complete ophthalmic examination, fluorescein angiography (FA), indocyanine green angiography (ICGA), optical coherence tomography, and OCTA. Results. CNV was confirmed in 18.6% of eyes using FA and ICGA and in 25.6% of eyes using OCTA. All cases of CNV were associated with irregular retinal pigment epithelial detachment. CT was increased in the affected eyes (mean 491.05 ± 91.98), but there were no statistically significant correlations between CT and CNV and PED occurrence (p=0.661 and p=0.614, resp.) and between CT and duration of the disease (p=0.940). Conclusions. OCTA detected CNV more frequently than other imaging modalities. CNV coexisted with irregular PED in all cases. CT was increased in eyes with chronic CSCR, but without any correlation with CNV occurrence; therefore, CT cannot be considered as a predictor of CNV occurrence. Further studies with a larger number of patients are needed to confirm these findings.


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.


2020 ◽  
pp. 112067212094401
Author(s):  
Chiara Comune ◽  
Daniela Montorio ◽  
Gilda Cennamo

Purpose: To detect the vessel density (VD) of the radial peripapillary capillary (RPC) in eyes affected by pathological myopia with or without a peripapillary intrachoroidal cavitation (PICC) and in eyes with PICC complicated by choroidal neovascularization (CNV), using optical coherence tomography angiography (OCTA). Methods: We prospectively enrolled highly myopic patients from January 2016 to December 2019 at the Eye Clinic of the University of Naples “Federico II.” We divided included patients into three groups: group 1 including patients with PICC complicated by CNV; group 2 including patients with PICC without complications; group 3 including patients with high myopia without PICC and CNV. One-way analysis of variance (ANOVA) followed by Bonferroni post hoc analysis was used to evaluate differences in VD of radial peripapillary capillary (RPC) in papillary whole, peripapillary regions and its sectors among the three groups. Results: We enrolled 12 highly myopic eyes with PICC complicated by CNV, 21 highly myopic eyes with PICC without CNV and 23 highly myopic eyes without PICC. The myopic eyes with PICC revealed a statistically significant reduction in VD of the RPC comparing to the other groups ( p < 0.001), especially in eyes affected by myopic PICC complicated by CNV ( p < 0.001). These results were similar analyzing the VD in different sectors of the peripapillary region among the three groups ( p < 0.001). Conclusion: OCTA detects the changes in peripapillary vascular density of highly myopic eyes. We demonstrated that the RPC vasculature is significantly influenced by the presence of PICC, especially in myopic eyes developing a CNV.


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.  


2021 ◽  
pp. 247412642110458
Author(s):  
Zofia Anna Nawrocka ◽  
Zofia Nawrocka ◽  
Jerzy Nawrocki

Purpose: A swept-source optical coherence tomography angiography (SS-OCTA) analysis of vasculature in vitreomacular traction (VMT) before and after surgery as well as 15 months’ “watchful waiting” follow-up data. Methods: A retrospective analysis of 38 eyes. Patients were divided into group 1: untreated (20 eyes); group 2: untreated, spontaneous release of traction (4 eyes); and group 3: vitrectomy (14 eyes). Results: In all cases, SS-OCTA of the choriocapillaris revealed a hyporeflective area, which disappeared after traction release. In group 1, none of the analyzed factors significantly changed. In group 2, visual acuity (VA) improved from 0.3 logMAR to 0.1 logMAR. None of the following parameters significantly changed: central choroidal thickness, superficial fovea avascular zone (sFAZ), deep fovea avascular zone (dFAZ), and vessel densities. In 1 eye a lamellar macular hole formed. Factors increasing the chances of spontaneous release of traction were width of traction and central retinal thickness ( P < .05). In group 3, VA improved from 0.27 Snellen (0.6 logMAR) to 0.44 Snellen (0.4 logMAR) ( P < .05). Postoperative OCTA revealed significant decreases in central retinal thickness ( P < .001), the parameters sFAZ, and dFAZ ( P < .05). Conclusions: sFAZ and dFAZ decreased after vitrectomy but not after spontaneous release of traction. VA was better in eyes with spontaneous release of traction. The degree of improvement in VA was greater in the vitrectomy group. In all cases a hyporeflective area is visible in the choriocapillaris layer in SS-OCTA. It disappears when traction is released. Early treatment, at least in patients with lower VA, might be beneficial.


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