Choriocapillaris Ischemia at the Leakage Point of Patients With Acute Central Serous Chorioretinopathy

Purpose: We aimed to determine ischemia of the choriocapillaris at the leakage point of patients with acute central serous chorioretinopathy (CSC) by optical coherence tomographic angiography (OCTA).Methods: A retrospective study of 38 eyes of 38 acute CSC patients with spontaneous complete resolution of subretinal fluid (SRF) was conducted and patients were followed for 3 months. Fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed at baseline. Best corrected visual acuity (BCVA) and OCTA were collected at baseline and at follow-up visits. An age- and refractive error-matched control group consisted of 40 eyes of 40 healthy people.Results: The BCVA of patients significantly improved at 1 and 3 months. At baseline, all eyes showed a decreased choriocapillaris vessel density. The mean vessel density of superficial choroid (VDSC) at the leakage point area was 44.18 ± 9.27, which increased to 54.31 ± 9.70 at 1 month (p < 0.001) and to 55.19 ± 6.46 at 3 months (p < 0.001). The mean vessel density ratio was 0.90 ± 0.16 at baseline, which increased to 0.96 ± 0.15 at 1 month (p = 0.037) and to 0.97 ± 0.08 at 3 months (p = 0.016). The highest VDSC of patients was lower than that of normal control (p < 0.001).Conclusions: The VDSC at the leakage point of acute CSC patients was significantly thinner and regularly increased with the recovery process, which suggested that ischemia might be one of the initiating factors in the pathogenesis of acute CSC.

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Spironolactone versus observation in the treatment of acute central serous chorioretinopathy

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2017-311096 ◽

2017 ◽

Vol 102 (8) ◽

pp. 1060-1065 ◽

Cited By ~ 13

Author(s):

Xinghong Sun ◽

Yuanlu Shuai ◽

Wangyi Fang ◽

Jia Li ◽

Weizhong Ge ◽

...

Keyword(s):

Treatment Group ◽

Central Serous Chorioretinopathy ◽

Complete Resolution ◽

Subretinal Fluid ◽

Control Group ◽

Significant Difference ◽

Registration Number ◽

Acute Central Serous Chorioretinopathy ◽

The Mean ◽

Randomised Controlled

PurposeTo evaluate the efficacy of oral spironolactone in patients with acute central serous chorioretinopathy (CSC).MethodsThis is a prospective, randomised controlled clinical study. Thirty patients with acute CSC were the participants, including 18 patients who were treated with spironolactone (40 mg orally, twice daily) for 2 months in the experimental group and 12 patients who received observation in the control group. Main outcome measures included the proportion of eyes achieving complete resolution of subretinal fluid (SRF), changes in central macular thickness (CMT), the height of SRF (SRFH), best corrected visual acuity (BCVA) and subfoveal choroidal thickness (SFCT). The follow-up period was 2 months.ResultsComplete resolution of SRF was achieved in 55.6% (10/18) and 8.3% (1/12) of the eyes in the treatment group and the control group, respectively, at 2 months (p=0.018). The mean CMT and SRFH decreased significantly at each visit in both groups (p<0.05), and there was significant difference between the two groups at 2 months (p<0.05 and p<0.05, respectively). BCVA (in logarithm of the minimum angle of resolution; mean) improved in both groups at 2 months (p<0.05). In the treatment group, the mean baseline SFCT significantly decreased from 502.50±87.38 µm to 427.44±74.37 µm at 2 months (p<0.01), while the change from baseline (from 480.33±102.38 µm to 463.75±100.63 µm) was not significant in the control group (p=0.195). But the differences between the two groups in BCVA and SFCT were not significant.ConclusionsOral spironolactone is more effective with a faster absorption of SRF than observations. It is a promising treatment for acute CSC.Trial registration numberChiCTR-IPR-16008428, Results.

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Oral Eplerenone Versus Observation in the Management of Acute Central Serous Chorioretinopathy: A Prospective, Randomized Comparative Study

Pharmaceuticals ◽

10.3390/ph13080170 ◽

2020 ◽

Vol 13 (8) ◽

pp. 170

Author(s):

Ramesh Venkatesh ◽

Arpitha Pereira ◽

Chaitra Jayadev ◽

Vishma Prabhu ◽

Aditya Aseem ◽

...

Keyword(s):

Treatment Group ◽

Central Serous Chorioretinopathy ◽

Subretinal Fluid ◽

Control Group ◽

Symptom Duration ◽

Imaging Features ◽

Observation Group ◽

Fellow Eye ◽

Beneficial Effects ◽

Acute Central Serous Chorioretinopathy

In this prospective, interventional case-control study, 58 patients with unilateral acute central serous chorioretinopathy (CSCR) were recruited. Patients ≥ 18 years age, presenting with first episodes of acute CSCR, were included. Acute CSCR was defined by the presence of subretinal fluid (SRF) and symptoms for <12 weeks duration with no clinical or imaging features of chronicity. Patients were alternately divided into treatment (Table Eplerenone 50 mg/day for minimum 1 month) and observation groups. Vision, SRF height and subfoveal choroidal thickness (SFCT) were checked at 1-, 2- and 3-months in both eyes of each group. Each group had 29 eyes. Mean age was 40.4 ± 7.1 and 43.3 ± 8.34 years in treatment and observation group, respectively. Mean symptom duration was 6.46 ± 1.45 and 5.87 ± 2.09 weeks, respectively. Vision improvement to 6/6 was seen in 92%, 100% and 100% cases in treatment group and 74%, 86% and 100% in control group at each visit, respectively. Complete SRF resolution in the treatment group was noted in 45%, 55% and 62% cases at each respective monthly visit. In the observation group, complete SRF resolution was noted in 10%, 21% and 31% at 1-, 2- and 3-month visits, respectively. SRF (p < 0.001) and SFCT (p < 0.001) reduction was noted in the affected eye of both groups. SFCT was reduced in the fellow eye after treatment (p = 0.005) compared to the observation group (p = 0.276). In conclusion, oral eplerenone achieves faster SRF resolution and vision improvement in acute CSCR. Additionally, it shows beneficial effects on the fellow eye.

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The effect of selective retina therapy for bevacizumab-resistant chronic central serous chorioretinopathy

Ophthalmologica ◽

10.1159/000520187 ◽

2021 ◽

Author(s):

Seung Hee Jeon ◽

Minhee Kim ◽

Jiyoung Lee ◽

Young-Jung Roh

Keyword(s):

Central Serous Chorioretinopathy ◽

Retrospective Cohort ◽

Subretinal Fluid ◽

Treatment Results ◽

Fundus Fluorescein Angiography ◽

Chronic Central Serous Chorioretinopathy ◽

Selective Retina Therapy ◽

Corrected Visual Acuity ◽

The Mean ◽

Anatomical Outcomes

Purpose: To evaluate the efficacy of selective retina therapy (SRT), used in conjunction with real-time feedback dosimetry (RFD), in the treatment of bevacizumab-resistant chronic central serous chorioretinopathy (CSC). Patients and Methods: In this retrospective cohort study, 22 eyes of 22 patients with anti-VEGF-resistant chronic CSC, showing focal or diffuse foveal leakages on fundus fluorescein angiography (FFA), were included. After evaluation of the test spots at temporal arcades, SRT (wavelength, 527 nm; pulse repetition rate, 100 Hz; ramping over maximal 15 micropulses; and spot diameter, 200 µm) using RFD was applied to the leakage sites observed on FFA. Changes in the mean best-corrected visual acuity (BCVA), central macular thickness (CMT), and subretinal fluid (SRF) height were evaluated at baseline and at 1, 3, 6, 9, and 12 months following treatment. Results: SRF completely resolved in 81.8% (18/22 eyes) cases at 12-months post-treatment. The mean BCVA (logMAR) improved from 0.49 ± 0.29 at baseline to 0.43 ± 0.36 at 12 months (p = 0.067). The mean BCVA gain was 0.06 logMAR, equivalent to 3 ETDRS letters. The CMT significantly decreased from 323 ± 85.6 µm at baseline to 221.5 ± 60.4 µm at 12 months (p < 0.001). The mean SRF height also significantly decreased from 174.6 ± 86.4 µm at baseline to 35.1 ± 75.4 µm at 12 months (p < 0.001). Conclusion: SRT showed favorable visual and anatomical outcomes in patients with bevacizumab-resistant chronic CSC.

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Effect of amblyopia treatment on macular microvasculature in children with anisometropic amblyopia using optical coherence tomographic angiography

Scientific Reports ◽

10.1038/s41598-020-79585-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Tengyue Zhang ◽

Shiyong Xie ◽

Yangchen Liu ◽

Caihong Xue ◽

Wei Zhang

Keyword(s):

Macular Thickness ◽

Vessel Density ◽

Control Group ◽

Optical Coherence ◽

Anisometropic Amblyopia ◽

Capillary Plexus ◽

The Mean ◽

Tomographic Angiography ◽

And Control ◽

Scan Pattern

AbstractTo measure the retinal microvascular density in patients with anisometropic amblyopia using optical coherence tomographic angiography (OCTA) and to evaluate the effects of successful amblyopia treatment on microvasculature in retina. 59 children (5–12 years old) including 22 newly diagnosed unilateral anisometropic amblyopia, 16 recovered unilateral anisometropic amblyopia, and 21 control children were imaged with OCTA using 6 × 6-mm macular scan pattern. Vessel densities of the superficial capillary plexus (SCP), the deep capillary plexus (DCP), and the overall macular thickness were acquired and compared among the three groups. After adjustment for axial length, the amblyopia group showed lower macular vessel density in the SCP (P = 0.005) and in the DCP (P = 0.004) compared with that of the control group. However, for the recovered amblyopia group, no difference of vessel density was found when compared with the control group in both the SCP (P = 0.548) and the DCP (P = 0.124). No difference of the mean macular thickness was found among three groups (P ≥ 0.15). Children with anisometropic amblyopia have reduced macular vessel density in OCTA, while no difference of macular vessel density was found between the recovered amblyopic and control eyes. Macular thickness showed no difference in anisometropic amblyopia and remained unchanged after amblyopic treatment.

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Comparison of Retinal Layer Thickness and Capillary Vessel Density in the Patients with Spontaneously Resolved Acute Central Serous Chorioretinopathy

Journal of Clinical Medicine ◽

10.3390/jcm10010045 ◽

2020 ◽

Vol 10 (1) ◽

pp. 45

Author(s):

Kyu Jin Han ◽

Hyeong Ju Kim ◽

Je Moon Woo ◽

Jung Kee Min

Keyword(s):

Visual Acuity ◽

Layer Thickness ◽

Central Serous Chorioretinopathy ◽

Subretinal Fluid ◽

Vessel Density ◽

Foveal Avascular Zone ◽

Retinal Layer ◽

Healthy Controls ◽

Retrospective Case ◽

Capillary Vessel

We investigate retinal layer thickness and capillary vessel density (VD) in the patients with central serous chorioretinopathy (CSC) who recovered spontaneously and evaluate the correlation between the changes in these values and visual outcomes using swept-source optical coherence tomography (SS-OCT) and OCT angiography (OCTA). This retrospective case–control study included 34 eyes of 34 patients with spontaneously resolved acute CSC. The changes in retinal layer thickness and capillary VD were examined using SS-OCT and OCTA after complete resolution of subretinal fluid (SRF). The fellow eyes and 34 healthy eyes were used as controls. In the eyes with CSC, the outer retinal layer was significantly thinner than in the eyes of fellow and healthy controls. The foveal avascular zone area and VDs in the superficial and deep capillary plexus in the eyes with CSC were not significantly different from those in the eyes of fellow and healthy controls. The VD of the choriocapillaris in the eyes with CSC was significantly lower than that in the eyes of fellow and healthy controls. Correlation analyses revealed that the outer retinal layer thickness and initial visual acuity were positively correlated with the final visual acuity. Furthermore, the initial SRF area and height were negatively correlated with the outer retinal layer thickness after SRF resolution. Attenuation of outer retinal layer thickness and decreased VD of the choriocapillaris were observed in the eyes with spontaneously resolved acute CSC. The outer retinal layer thickness could be an important visual predictor of CSC.

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Retinal vascular findings in patients with COVID-19

Therapeutic Advances in Ophthalmology ◽

10.1177/25158414211030419 ◽

2021 ◽

Vol 13 ◽

pp. 251584142110304

Author(s):

Emre Aydemir ◽

Alper Halil Bayat ◽

Burak Ören ◽

Halil Ibrahim Atesoglu ◽

Yasin Şakir Göker ◽

...

Keyword(s):

Healthy Subjects ◽

Fundus Photography ◽

Control Group ◽

Fundus Fluorescein Angiography ◽

University Of Wisconsin ◽

Retinal Vascular Caliber ◽

Retinal Artery ◽

The Mean ◽

And Gender ◽

College Of Engineering

Purpose: The purpose of this study was to compare the retinal vascular caliber of COVID-19 patients with that of healthy subjects. Methods: This was a prospective case–control study. Forty-six patients who had COVID-19 were successfully treated, and 38 age- and gender-matched healthy subjects were enrolled in this study. Fundus photography was taken using fundus fluorescein angiography (FA; Visucam 500; Carl Zeiss Meditec, Jena, Germany). Retinal vascular caliber was analyzed with IVAN, a semi-automated retinal vascular analyzer (Nicole J. Ferrier, College of Engineering, Fundus Photography Reading Center, University of Wisconsin, Madison, WI, USA). Central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and artery–vein ratio (AVR) were compared between groups. Results: The mean age was 37.8 ± 9.5 years in the COVID-19 group ( n = 46) and 40 ± 8 years in the control group ( n = 38) ( p = 0.45). The mean CRAE was 181.56 ± 6.40 in the COVID-19 group and 171.29 ± 15.06 in the control group ( p = 0.006). The mean CRVE was 226.34 ± 23.83 in the COVID-19 group and 210.94 ± 22.22 in the control group ( p = 0.044). AVR was 0.81 ± 0.09 in the COVID-19 group and 0.82 ± 0.13 in the control group ( p = 0.712). Conclusion: Patients who had COVID-19 have vasodilation in the retinal vascular structure after recovery. As they may be at risk of retinal vascular disease, COVID-19 patients must be followed after recovery.

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Factors Predicting Response to Selective Retina Therapy in Patients with Chronic Central Serous Chorioretinopathy

Journal of Clinical Medicine ◽

10.3390/jcm11020323 ◽

2022 ◽

Vol 11 (2) ◽

pp. 323

Author(s):

Minhee Kim ◽

Seung Hee Jeon ◽

Ji-young Lee ◽

Seung-hoon Lee ◽

Young-jung Roh

Keyword(s):

Central Serous Chorioretinopathy ◽

Subretinal Fluid ◽

Central Macular Thickness ◽

Fundus Fluorescein Angiography ◽

Chronic Central Serous Chorioretinopathy ◽

Safety And Efficacy ◽

Selective Retina Therapy ◽

Corrected Visual Acuity ◽

Anatomical Outcomes ◽

Best Corrected Visual Acuity

This retrospective study aimed to assess the safety and efficacy of selective retina therapy (SRT) with real-time feedback-controlled dosimetry (RFD) for chronic central serous chorioretinopathy (CSC) and to evaluate factors predictive of treatment response. We included 137 eyes of 135 patients with chronic CSC. SRT was performed to cover each of the leakage areas on fundus fluorescein angiography. Changes in mean best-corrected visual acuity (BCVA), central macular thickness (CMT), and subretinal fluid (SRF) height were evaluated at baseline and at 3 and 6 months after treatment. Complete SRF resolution was observed in 52.6% (72/137 eyes) and 90.5% (124/137 eyes) at 3 and 6 months, respectively. Mean BCVA (logMAR) significantly improved from 0.41 ± 0.31 at baseline to 0.33 ± 0.31 at month 6 (p < 0.001). Mean CMT significantly decreased from 347.67 ± 97.38 μm at baseline to 173.42 ± 30.95 μm at month 6 (p < 0.001). Mean SRF height significantly decreased from 187.85 ± 97.56 µm at baseline to 8.60 ± 31.29 µm after 6 months (p < 0.001). Baseline SRF height was a significant predictive factor for retreatment requirement (p = 0.008). In conclusion, SRT showed favorable anatomical outcomes in patients with chronic CSC. A higher baseline SRF height was a risk factor for retreatment.

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Detection of Choroidal Neovascularization in Central Serous Chorioretinopathy Using Optical Coherence Tomographic Angiography

Ophthalmologica ◽

10.1159/000448630 ◽

2016 ◽

Vol 236 (2) ◽

pp. 114-121 ◽

Cited By ~ 12

Author(s):

Sisi Weng ◽

Lei Mao ◽

Suqin Yu ◽

Yuanyuan Gong ◽

Lu Cheng ◽

...

Keyword(s):

Fluorescein Angiography ◽

Choroidal Neovascularization ◽

Central Serous Chorioretinopathy ◽

Imaging Techniques ◽

Conventional Imaging ◽

Optical Coherence ◽

Outer Retina ◽

Fundus Fluorescein Angiography ◽

Eye Examination ◽

Tomographic Angiography

Purpose: To demonstrate the detection of choroidal neovascularization (CNV) in clinically diagnosed central serous chorioretinopathy (CSC) by optical coherence tomographic angiography (OCTA). Methods: Seventy-five eyes of 70 patients were included. OCTA was performed on each patient. Two trained readers evaluated the images independently to confirm the diagnosis and identify CNV at the level of the outer retina. Results: All studied eyes presented characteristics consistent with CSC based on eye examination and traditional imaging technologies, including fundus fluorescein angiography, which showed no evidence of CNV. However, OCTA revealed definite abnormal vascularization at the level of the outer retina in 8 eyes (10.7%) of 8 patients (11.4%). Conclusion: This study suggests that in some cases of CSC, OCTA could be an alternative option to detect CNV that is undetectable by other conventional imaging techniques.

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Evaluation of acute central serous chorioretinopathy using enhanced depth imaging OCT and multifocal electroretinography

10.21203/rs.3.rs-26842/v1 ◽

2020 ◽

Author(s):

In Hwan Hong ◽

In Boem Chang ◽

Jae Ryong Han

Keyword(s):

Central Serous Chorioretinopathy ◽

Choroidal Thickness ◽

Serous Retinal Detachment ◽

Subretinal Fluid ◽

Multifocal Electroretinography ◽

Enhanced Depth Imaging ◽

Implicit Time ◽

Depth Imaging ◽

Acute Central Serous Chorioretinopathy ◽

Normal Controls

Abstract Background To evaluate the functional and structural abnormalities in patients with acute central serous chorioretinopathy (CSC) by multifocal electroretinography (mfERG) and enhanced depth imaging optical coherence tomography (EDI-OCT) Methods This prospective observational study included 57 patients with unilateral CSC. Both eyes underwent mfERG and EDI-OCT. Peak amplitudes and implicit times of the ﬁrst kernel responses were analyzed and compared with those in 25 age-matched normal controls. Correlational analyses were performed between the mfERG results and EDI-OCT parameters. The thicknesses of the central retina, subretinal fluid, and choroid was measured at baseline and 3 months later. Results Compared with the normal controls, the amplitude and implicit time on mfERG were significantly impaired in the area with serous retinal detachment (SRD). The P1 amplitude and implicit time of the areas beyond the SRD were also found to be significantly impaired in the affected eyes. Eyes with a greater reduction in SRD had a less impaired mfERG response in fellow eyes than those whose retinal detachments were not spontaneously decreased by more than 90% after 3 months. Correlational analysis did not reveal any significant correlations between mfERG values and OCT parameters except for central choroidal thickness. The subfoveal choroidal thickness was negatively correlated with the mfERG parameters. Conclusion The findings of this study indicate diffuse functional impairment in acute CSC which involves both eyes and areas beyond the SRD. The retinal response of the unaffected eye was associated with regression of SRD and functional retinal abnormality is correlated with pathological changes in the choroid.

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