scholarly journals Changes in Retinal and Choroidal Vascularity in Eyes with Acute Central Serous Chorioretinopathy Using Optical Coherence Tomography Angiography

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.

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.


Author(s):  
Pasha Anvari ◽  
Amin Najafi ◽  
Reza Mirshahi ◽  
Mahsa Sardarinia ◽  
Maryam Ashrafkhorasani ◽  
...  

Purpose: To compare the area of the foveal avascular zone (FAZ) in the superficial and deep retinal layers using two different spectral-domain optical coherence tomography angiography (OCTA) devices. Methods: A cross-sectional comparative study was conducted to obtain macular OCTA images from healthy subjects using Optovue RTVue XR Avanti (Optovue, Inc, Fremont, CA) and Spectralis HRA+OCTA (Heidelberg Engineering, Heidelberg, Germany). Two independent trained graders measured the FAZ area using automated slab segmentation. The FAZ area in the superficial and deep retinal layers were compared. Results: Twenty-three eyes of 23 subjects were included. The graders agreement was excellent (>0.86) for all measurements. The mean FAZ area was significantly larger at the superficial retinal layer as compared to the deep retinal layer on both devices (0.31 ± 0.08 mm2 vs 0.26 ± 0.08 mm2 in Optovue and 0.55 ± 0.16 mm2 vs 0.36 ± 0.13 mm2 in Spectralis, both P < 0.001). The mean FAZ area was significantly greater in the superficial and deep retinal layers using Spectralis as compared to Optovue measurements (P < 0.001 for both comparisons). Conclusion: In contrast to previous reports, the FAZ area was larger in the superficial retina as compared to deep retinal layers using updated software versions. Measurements from different devices cannot be used interchangeably.


2021 ◽  
Author(s):  
Ali Torkashvand ◽  
Hamid Riazi-Esfahani ◽  
Fariba Ghassemi ◽  
Elias Khalil Pour ◽  
Babak Masoomian ◽  
...  

Abstract BACKGROUND: To assess the impact of brachytherapy on macular microvasculature utilizing optical coherence tomography angiography (OCTA) in treated choroidal melanoma.METHODS: In this retrospective observational case series, we reviewed the recorded data of the patients with choroidal melanoma treated with rheuthenium-106 (106Ru) plaque radiotherapy with follow-up period of more than 6 months. Automatically measured OCTA retinal parameters were analyzed after image processing. The non-irradiated fellow eye is considered as the control.RESULTS: Thirty-one eyes of 31 patients with the mean age of 51.1 years were recruited. Six eyes had no radiation maculopathy (RM). From 25 eyes with RM, nine eyes (36%) revealed a burnout macular microvasculature with imperceptible vascular details. Foveal and optic disc radiation dose had the highest value to predict the burnout pattern (ROC, AUC: 0.763, 0.727). Superficial and deep foveal avascular zone (FAZ) were larger in irradiated eyes in comparison to healthy eyes (1629 µm2 vs. 428 µm2, P =0.005; 1837 µm2 vs 268 µm2, P =0.021; respectively). Foveal and parafoveal vascular area density (VAD) and vascular skeleton density (VSD) in both superficial and deep capillary plexus (SCP and DCP) were decreased in all irradiated eyes in comparison with control eyes (P< 0.001). Compared with fellow healthy eyes, irradiated eyes without RM had significantly lower VAD and VSD at foveal and parafoveal DCP (all P<0.02). However, these differences at SCP were not statistically significant. CONCLUSION: The OCTA is a valuable tool for evaluating RM. Initial subclinical microvascular insult after 106Ru brachytherapy is more likely to occur in DCP. The deep FAZ area was identified as a more critical biomarker of BCVA than superficial FAZ in these patients.


2020 ◽  
Vol 5 (2) ◽  
pp. 1-8
Author(s):  
Mika Suda ◽  
Yuji Yoshikawa ◽  
Gaku Terauchi ◽  
Soiti Matsumoto ◽  
Takuhei Shoji ◽  
...  

Purpose: The aim of this study was to evaluate the foveal avascular zone (FAZ) of healthy subjects and examine the magnification effect. Methods: A total of 33 healthy volunteers were enrolled and all subjects were eligible for analysis. Optical coherence tomography angiography (OCTA) examination scanned 3 × 3 mm of the macular area. The FAZ area was measured on the superficial OCTA en face image with and without correction by axial length. The relationship between changes in the FAZ area after correction with the axial length was examined. Results: The mean age was 21.9 ± 0.6 years. The mean axial length was 24.87 ± 1.17 mm and mean spherical equivalent (SE) value was –3.64 ± 2.83 diopters (D). The FAZ area was 0.26 ± 0.10 mm2 before the axial length correction and 0.27 ± 0.10 mm2 after the correction. In the eyes that had an axial length longer than or equal to 26 mm or SE less than or equal to –6 D, the FAZ area after correction was significantly larger than that before correction (p < 0.01). The change of FAZ area after correction with axial length was significantly correlated with the axial length (R2 = 0.88, p < 0.01) or SE value (R2 = 0.55, p < 0.01). Conclusion: FAZ areas were comparable to previous reports. In high myopic cases, the magnification effect needs to be considered when evaluating the FAZ area.


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.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Linning Guo ◽  
Chenlei Zhu ◽  
Ziqi Wang ◽  
Zhiqiang Gao ◽  
Zongduan Zhang ◽  
...  

Purpose. To evaluate the effects of the menstrual cycle on the retinal vascular status of healthy women by optical coherence tomography angiography (OCTA). Materials and Methods. Healthy women with regular natural menstrual cycles of 28 to 30 days were recruited for this prospective study. The women’s retinal vascular status was measured by OCTA at 3 time points: the early follicular, ovulatory, and midluteal phases of the menstrual cycle. The main outcome measures were foveal avascular zone (FAZ) parameters, perfusion density (PD) percentage in the superficial retinal capillary plexus (SCP), and PD percentage in the deep retinal capillary plexus (DCP). The mean arterial pressure (MAP), spherical equivalent (SE), best-corrected visual acuity (BCVA), intraocular pressure (IOP), and axial (AL) were also measured in a same menstrual cycle. Results. In total, 62 right eyes of 62 women were included in the study. The mean age was 27.0 ± 1.73 (range, 24 to 31) years, and the mean menstrual cycle was 28.90 ± 0.84 (range, 28 to 30) days. The mean values of the DCP-PD parameters were significantly decreased in the nasal and inferior ETDRS subfields during the ovulatory phase. The mean DCP-PD in the nasal ETDRS subfield in the early follicular, ovulatory, and luteal phases was 54.11 ± 2.85, 56.39 ± 3.03, and 55.70 ± 3.27, respectively. The mean DCP-PD in the inferior ETDRS subfield in the early follicular, ovulatory, and midluteal phases was 52.90 ± 3.30, 54.86 ± 2.51, and 55.21 ± 2.64, respectively. No significant differences were found in MAP, SE, AL, IOP, FAZ area, or other quadrants of PD parameters, and no significant correlation was found between parameters by OCTA and age, MAP,SE, axial length, or IOP. Conclusions. The DCP-PD decreased in the nasal and inferior ETDRS subfields during the ovulatory phase in our study. This may indicate the need to consider the menstrual phase when interpreting DCP-PD parameters by OCTA in healthy women.


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.


2020 ◽  
Vol 30 (3) ◽  
pp. 600-607
Author(s):  
Elif Güler Kazancı ◽  
Muhammet Furkan Korkmaz ◽  
Mehmet Erol Can

Purpose: The purpose was to evaluate retinal vascular parameters by optical coherence tomography angiography in β-thalassemia major patients. Methods: Thirty-three patients with β-thalassemia major (study group) and 29 healthy children (control group) were enrolled in the study. All subjects underwent a complete ocular examination. The mean foveal avascular zone, non-flow area, foveal avascular zone perimeter, acircularity index of foveal avascular zone, foveal density, the superficial capillary plexus, and deep capillary plexus were scanned using 6 × 6 mm optical coherence tomography angiography scans centered on the macula. Superficial capillary plexus and deep capillary plexus were also scanned centered on the optic disk. We collected data on histories of patients, and hemoglobin and ferritin were also studied from both groups. Results: The mean age was 13.85 ± 4.69 years (range: 4–21 years) in β-thalassemia major group and 12.59 ± 3.66 years (range: 6–18 years) in the control group. The mean foveal avascular zone value was 0.265 ± 0.11 mm2 in the study group and 0.296 ± 0.12 mm2 in the control group. The mean non-flow area value was 0.468 ± 0.12 mm2 in the study group and 0.479 ± 0.14 mm2 in the control group ( p > 0.05). Differences in the mean values for foveal density and acircularity index were statistically significant between the study group and control group ( p < 0.05, p = 0.026, and p = 0.026, respectively). Superficial capillary plexus and deep capillary plexus were not a significant difference between the study and control groups in 6 × 6 mm scans on macula and 4.5 × 4.5 mm scans on optic disk area ( p > 0.05). Acircularity index was negatively correlated ( r = −0.292, p = 0.026), and foveal density was positively correlated with hemoglobin ( r = 0.292, p = 0.026). Conclusion: By using optical coherence tomography angiography, we detected foveal microvascular changes in young β-thalassemia patients before significant ocular anomalies development.


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