Mid-Phase Hyperfluorescent Plaques Seen on Indocyanine Green Angiography in Patients with Central Serous Chorioretinopathy

(1) Indocyanine green angiography (ICG-A) shows the presence of mid-phase hyperfluorescent area in central serous chorioretinopathy (CSCR). However, their exact meaning remains uncertain. (2) The clinical and multimodal imaging findings of 100 patients (133 eyes) with CSCR, including the enhanced-depth-imaging OCT (EDI-OCT), blue-light fundus autofluorescence (BAF), fluorescein and indocyanine green angiography (FA and ICG-A) findings were reviewed. Mid-phase hyperfluorescent plaques (MPHP) were defined as fairly well circumscribed hyperfluorescent regions during the midphase of the ICG-A. The association between MPHP and other clinical/imaging parameters was assessed using a multiple logistic regression analysis. (3) MPHP were detected in 59.4% of eyes with CSCR. The chronic form of the disease, the presence of irregular pigment epithelium detachments (PED) and the retinal pigment epithelium (RPE) changes seen on FA were associated with the presence of MPHP in the multivariate analysis (p = 0.015; p = 0.018 and p = 0.002; respectively). OCT showed RPE bulges or PED in 98.7% of areas with MPHP and BAF showed changes in 57.3% of areas with MPHP. (4) MPHP were associated with a chronic form of CSCR and colocated with PED or RPE bulges. MPHP should be recognized as a sign of early RPE dysfunction before it is detected with BAF.

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Assessment of Hypofluorescent Foci on Late-Phase Indocyanine Green Angiography in Central Serous Chorioretinopathy

Journal of Clinical Medicine ◽

10.3390/jcm10102178 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2178

Author(s):

Ari Shinojima ◽

Yoko Ozawa ◽

Atsuro Uchida ◽

Norihiro Nagai ◽

Hajime Shinoda ◽

...

Keyword(s):

Indocyanine Green ◽

Central Serous Chorioretinopathy ◽

Indocyanine Green Angiography ◽

Near Infrared ◽

Pigment Epithelium ◽

Fundus Autofluorescence ◽

Retinal Pigment ◽

Late Phase ◽

Standard Deviation Range ◽

Simple Regression Analysis

To assess the hypofluorescent foci (HFF) on late-phase indocyanine green angiography (ICGA) in central serous chorioretinopathy (CSC) using short-wavelength fundus autofluorescence (SW-FAF), near-infrared autofluorescence (NIR-AF), and fluorescein angiography (FA). The HFF area on late-phase ICGA for at least 20 min was compared with the area of abnormal foci on SW-FAF, NIR-AF, and FA. In 14 consecutive patients (12 men, including 1 with bilateral CSC; and 2 women with unilateral CSC), four kinds of images of 27 eyes were acquired. The mean age ± standard deviation (range) was 46 ± 9.2 years (31–69 years). The HFF on late-phase ICGA were found in 23 eyes (in all 15 CSC eyes and the contralateral 8 eyes). From the results of simple regression analysis, we obtained the following three formulas. The HFF area on ICGA = 1.058 × [abnormal SW-FAF area] + 0.135, the HFF area on ICGA = 1.001 × [abnormal NIR-AF area] + 0.015, and the HFF area on ICGA = 1.089 × [abnormal FA area] + 0.135. Compared to SW-FAF and FA, NIR-AF was found to be the easiest method to detect the HFF on late-phase ICGA, which may indicate melanin abnormalities, especially a decrease, in the retinal pigment epithelium.

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Pachychoroid pigment epitheliopathy in fellow eyes of patients with unilateral central serous chorioretinopathy

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2017-310724 ◽

2017 ◽

Vol 102 (4) ◽

pp. 473-478 ◽

Cited By ~ 14

Author(s):

M Giray Ersoz ◽

Murat Karacorlu ◽

Serra Arf ◽

Mumin Hocaoglu ◽

Isil Sayman Muslubas

Keyword(s):

Central Serous Chorioretinopathy ◽

Pigment Epithelium ◽

Fundus Autofluorescence ◽

Retinal Pigment ◽

Enhanced Depth Imaging ◽

Systemic Hypertension ◽

Foveal Thickness ◽

Central Foveal Thickness ◽

Pachychoroid Pigment Epitheliopathy ◽

Fellow Eyes

AimsTo investigate the prevalence of pachychoroid pigment epitheliopathy (PPE) in fellow eyes of patients with unilateral central serous chorioretinopathy (CSC) and to determine differences between patients with PPE, uncomplicated pachychoroid (UCP) and normal fellow eyes.MethodsWe retrospectively reviewed 536 patients with CSC. Demographic and medical data, spectral domain optical coherence tomography scans with enhanced depth imaging mode, infrared reflectance images and fundus autofluorescence images were obtained from the patients’ medical records.Results254 (47.4%) of 536 patients had bilateral CSC. The female to male ratio was 1/2.8 in all patients with CSC. In patients with unilateral CSC (282 patients), 61% of fellow eyes had PPE, 30.8% had UCP and 8.2% were normal. There were no significant differences between patients with PPE, UCP and normal eyes in age, duration of disease, sex, presence of systemic hypertension, steroid use, psychopharmacological medication use, refractive error or central foveal thickness. Eyes with PPE and UCP did not differ regarding subfoveal choroidal thickness. In eyes with PPE (172 eyes), 77.3% had retinal pigment epithelium (RPE) bumps and 43% had pigment epithelium detachment.ConclusionPPE is common in fellow eyes of patients with CSC. There is no difference between PPE and UCP regarding demographic characteristics and medical features.

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Accordance of Indocyanine Green Angiography and Optical Coherence Tomography Angiography in Visualization of Neovascularization Associated with Chronic Central Serous Chorioretinopathy

Ophthalmology in Russia ◽

10.18008/1816-5095-2018-2s-254-260 ◽

2018 ◽

Vol 15 (2S) ◽

pp. 254-260

Author(s):

E. K. Pedanova ◽

O. B. Klepinina ◽

D. A. Buryakov

Keyword(s):

Optical Coherence Tomography ◽

Indocyanine Green ◽

Central Serous Chorioretinopathy ◽

Indocyanine Green Angiography ◽

Optical Coherence Tomography Angiography ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Diagnostic Methods ◽

Optical Coherence ◽

Chronic Central Serous Chorioretinopathy

Purpose: to compare informativity and accordance of indocyanine green angiography (ICGA) and optical coherence tomography angiography (OCT-A) data in visualization of neovascularization associated with chronic central serous chorioretinopathy. Patients andMethods. Twenty one eye of 21 patients (aged 51.0 ± 8.4 years old) with chronic central serous chorioretinopathy (CSR) and assumed choroidal neovascularisation (CNV) with «double layer» sign on optical coherence tomography scans were enrolled in this study. ICGA on Spectralis HRA+OCT, (Heidelberg Engeneering, Germany) and OCT-A on RTVue XR Avanti (Optovue, USA) were performed to evaluate CNV. The assessment of obtained pictures was examined by two experts.Results. Both diagnostic methods have shown similar results. CNV has been revealed in 11 of 21 eyes by ICGA imaging while OCT-A confirmed neovascularization in 13 eyes — with no statistical difference between methods (p = 0.74, χ2). CNV has not been diagnosed in 10 cases by ICGA and in 8 cases by OCT-A (p = 0.69). However, the consistency of the two methods in CNV evaluation while pairwise comparison of angiography data has been confirmed only in 8 eyes. The absence of CNV has been confirmed in 6 eyes — mostly in patients with CSR recurrence. One third of patients (7 of 21 eyes) have not shown consistence of two methods. The OCT-A visualization of CNV could be poor because of subretinal deposits and pigment-related signal blocking. In cases of diffuse retinal pigment epithelium atrophy the neovascular network cannot been seen on ICGA images while well visualized on OCT-A.Conclusion. The informativity of ICGA and OCT-A in visualization of neovascularization associated with chronic central serous chorioretinopathy is similar. For the best data interpretation the condition of neurosensory retina and pigment retinal epitheluium should be taken into account. OCT-A is more preferable in cases of diffuse epitheliopathy, while the neovascularization activity and leakage points is better seen on ICGA.

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Optical Coherence Tomography Characteristics of the Choroid Underlying Congenital Hypertrophy of the Retinal Pigment Epithelium

Ocular Oncology and Pathology ◽

10.1159/000504712 ◽

2020 ◽

Vol 6 (4) ◽

pp. 238-243

Author(s):

Jasmine H. Francis ◽

Ethan K. Sobol ◽

Molly Greenberg ◽

Robert Folberg ◽

David H. Abramson

Keyword(s):

Optical Coherence Tomography ◽

Retinal Pigment Epithelium ◽

Choroidal Thickness ◽

Retinal Thickness ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Enhanced Depth Imaging ◽

Optical Coherence ◽

Depth Imaging ◽

Congenital Hypertrophy

Purpose: This study evaluates and characterizes the choroid underlying congenital hypertrophy of the retinal pigment epithelium (CHRPE). Methods: Retrospective observational study of CHRPE at least 2 mm in diameter. Choroidal vascular architecture was qualitatively examined. Choroidal thickness was measured by 2 independent observers using enhanced depth imaging spectral domain optical coherence tomography. Results: Forty-six eyes of 46 patients with CHRPE were included. Thirty-two lesions had imaging sufficient for analysis. Haller’s layer was healthy in 18 (56%), thin in 13 (41%), and absent in 1 (2%). Sattler’s layer was atrophic in 30 (94%), and choriocapillaris was atrophic in 31 (97%). CHRPE with thinned Haller’s layer had significantly larger diameter. The mean sub-CHRPE choroidal thickness was 82.4 ± 7.9 µm, compared to a thickness of 148.4 ± 9.6 µm in the normal adjacent choroid (p < 0.0001). Mean retinal thickness overlying the CHRPE was 77.3 ± 4.3 µm, compared to a retinal thickness of 137.8 ± 2.9 µm overlying the normal adjacent choroid (p < 0.0001). Sub-CHRPE choroidal thickness was a mean of 56.2 ± 3.1% of the adjacent normal choroidal thickness. Conclusion: The underlying choroid CHRPE is thinner than the adjacent normal choroid. All layers of the choroid can be thin with a preference of the inner Sattler’s and choriocapillaris layers.

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Vogt-Koyanagi-Harada Disease and Birdshot Retinochoroidopathy, Similarities and Differences: A Glimpse into the Clinicopathology of Stromal Choroiditis, a Perspective and a Review

Klinische Monatsblätter für Augenheilkunde ◽

10.1055/a-0829-6763 ◽

2019 ◽

Vol 236 (04) ◽

pp. 492-510 ◽

Cited By ~ 4

Author(s):

Sina Elahi ◽

Carl Herbort

Keyword(s):

Optical Coherence Tomography ◽

Early Diagnosis ◽

Indocyanine Green ◽

Early Treatment ◽

Indocyanine Green Angiography ◽

Enhanced Depth Imaging ◽

Depth Imaging ◽

Imaging Optical Coherence Tomography ◽

Similarities And Differences ◽

Stromal Choroiditis

AbstractThe purpose of this work was to give a comprehensive and updated review on two primary stromal choroiditis entities, Vogt-Koyanagi-Harada disease (VKH) and birdshot retinochoroiditis (BRC). Their appraisal has become much more precise thanks to new investigational methods, such as indocyanine green angiography (ICGA) and enhanced depth imaging optical coherence tomography (EDI-OCT), which give substantially improved imaging access to the choroid. In this review, we focus on the crucial changes brought by this progress in the understanding, diagnosis, and management of these disorders. Application of these methods makes it possible to reach an early diagnosis, therefore allowing early treatment, which has led to a profound improvement in outcomes when compared to previous management.

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Review of spectral domain-enhanced depth imaging optical coherence tomography of tumors of the retina and retinal pigment epithelium in children and adults

Indian Journal of Ophthalmology ◽

10.4103/0301-4738.154384 ◽

2015 ◽

Vol 63 (2) ◽

pp. 128 ◽

Cited By ~ 36

Author(s):

CarolL Shields ◽

Janet Manalac ◽

Jarin Saktanasate ◽

JerryA Shields ◽

Chandana Das

Keyword(s):

Optical Coherence Tomography ◽

Retinal Pigment Epithelium ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Spectral Domain ◽

Enhanced Depth Imaging ◽

Optical Coherence ◽

Depth Imaging ◽

Imaging Optical Coherence Tomography

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Long-Term Effect of Half-Fluence Photodynamic Therapy on Fundus Autofluorescence in Acute Central Serous Chorioretinopathy

Journal of Ophthalmology ◽

10.1155/2020/8491712 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Martin Stattin ◽

Stefan Hagen ◽

Daniel Ahmed ◽

Eva Smretschnig ◽

Florian Frommlet ◽

...

Keyword(s):

Photodynamic Therapy ◽

Central Serous Chorioretinopathy ◽

Pigment Epithelium ◽

Fundus Autofluorescence ◽

Retinal Pigment ◽

Long Term Follow Up ◽

Acute Central Serous Chorioretinopathy ◽

Mean Differences

Purpose. To evaluate normalized short-wavelength fundus autofluorescence (SW-FAF) imaging changes over time as a predictive parameter for the retinal pigment epithelium (RPE) function in eyes compromised by acute central serous chorioretinopathy (CSCR) after indocyanine green angiography-guided verteporfin (Visudyne®, Novartis Pharma, Basel, Switzerland) photodynamic therapy (PDT) with a half-fluence rate (25 J/cm2). Methods. Quantitative data of SW-FAF grey values (SW-FAF GV) from a 350 μm (SW-350) and 1200 μm (SW-1200) diameter circle centered on the fovea and normalized with the level of SW-FAF GV in a 30° image of 20 eyes in 11 patients initially treated for unilateral acute symptomatic CSCR were collected and retrospectively analyzed after 7 years. A 2-sided t-test was calculated to explore the differences of SW-350 and SW-1200 between one month and the long-term follow-up. Results. Mean differences (95% CI) in SW-FAF GV between 1 month and 7 years after half-fluence PDT were 0.07 ± 0.11 for SW-350 ([95% CI: −0.002; 0.14], p=0.06) and 0.11 ± 0.15 for SW-1200 ([95% CI: 0.01; 0.21], p=0.03). Mean differences in SW-FAF GV of the contralateral untreated eye were 0.06 ± 0.14 for SW-350 ([95% CI: −0.04; 0.17], p=0.22) and 0.05 ± 0.13 for SW-1200 ([95% CI: −0.04; 0.15], p=0.22). Conclusion. After 7 years, normalized SW-FAF GV were significantly lower in eyes with resolved acute CSCR treated with reduced-fluence PDT compared to the follow-up after 1 month without correlation to explicit pattern changes or structural damages. Half-fluence PDT remains a safe and considerable treatment option in acute CSCR.

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Multimodal Imaging Evaluations of Focal Choroidal Excavations in Eyes with Central Serous Chorioretinopathy

Journal of Ophthalmology ◽

10.1155/2016/7073083 ◽

2016 ◽

Vol 2016 ◽

pp. 1-12 ◽

Cited By ~ 7

Author(s):

Yao Wang ◽

Zhi-Qing Chen ◽

Wei Wang ◽

Xiao-Yun Fang

Keyword(s):

Central Serous Chorioretinopathy ◽

Multimodal Imaging ◽

Retinal Pigment Epithelial ◽

Multispectral Imaging ◽

Pigment Epithelium ◽

Fundus Autofluorescence ◽

Retinal Pigment ◽

Chinese Patients ◽

Single Institution ◽

Focal Choroidal Excavation

Purpose. To investigate the prevalence and characteristics of focal choroidal excavation (FCE) concurrent with central serous chorioretinopathy (CSC) using multimodal imaging.Methods. This was a retrospective single-institution study. Clinical features and multimodal imaging findings were analyzed in eyes with CSC and FCEs, using imaging methods including optical coherence tomography (OCT), OCT angiography (OCTA), fluorescein angiography (FA), indocyanine green angiography (ICGA), fundus autofluorescence (FAF), and multispectral imaging.Results. Seventeen patients (4.8%) with 21 FCEs (19 eyes) were found among 351 consecutive Chinese patients with CSC. Chronic CSC represented 47.1% of those cases. Window defects in 12 lesions identified through FA and hypoautofluorescence in 13 lesions identified through FAF revealed retinal pigment epithelial attenuation. Choroidal hemodynamic disturbances characterized by localized filling defects at the excavation and circumferential hyperperfusion were validated by both ICGA and OCTA, which were similar to the angiographic features of normal chronic CSC. The hyperreflective tissue beneath FCE, observed on B-scan OCT, presented as intensive choroidal flow signals on OCTA.Conclusions. FCE is not uncommon in patients with CSC. Multimodal imaging suggested that the aberrant choroidal circulation might be a contribution factor for leakage from the dysfunctional retinal pigment epithelium at the area of excavation.

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Central Serous Chorioretinopathy in a Myopic Patient with Pachychoroid

Ophthalmology Point of Care ◽

10.5301/oapoc.0000007 ◽

2017 ◽

Vol 1 (1) ◽

pp. oapoc.0000007

Author(s):

Elon H.C. van Dijk ◽

Kasper L. de Roon Hertoge ◽

Camiel J.F. Boon

Keyword(s):

Central Serous Chorioretinopathy ◽

High Myopia ◽

Retinal Pigment Epithelial ◽

Pigment Epithelium ◽

Fundus Autofluorescence ◽

Retinal Pigment ◽

Fundus Photography ◽

Ophthalmological Examination ◽

Patient Presentation ◽

Pachychoroid Pigment Epitheliopathy

Introduction To report a case of central serous chorioretinopathy (CSC) associated with a retinal pigment epithelium detachment in a myopic patient with marked pachychoroid. Patient presentation Case report of a 37-year-old male patient with relatively high myopia (-5.00D in OD/-5.75D in OS), unilateral CSC, and bilateral retinal pigment epithelial detachments, pachychoroid, and choroidal hyperaemia. Standard ophthalmological examination and multimodal imaging, including fundus photography, fundus autofluorescence, spectral-domain and enhanced depth optical coherence tomography, and indocyanine green angiography were performed. Conclusions Findings characteristic for the spectrum of CSC/pachychoroid pigment epitheliopathy can be observed in patients with relatively high myopia. Based on the outcome of complete ophthalmological examination, this clinical picture can be discerned from other diseases, which is important for the optimal therapeutic approach.

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Optical Coherence Tomography Angiography (OCTA) findings in Serpiginous Choroiditis

10.21203/rs.2.23533/v3 ◽

2020 ◽

Author(s):

Sergio Macedo ◽

Dominika Pohlmann ◽

Matthias Lenglinger ◽

Uwe Pleyer ◽

Antonia M. Joussen ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Optical Coherence Tomography Angiography ◽

Pigment Epithelium ◽

Fundus Autofluorescence ◽

Retinal Pigment ◽

Vascular Lesions ◽

Enhanced Depth Imaging ◽

Optical Coherence ◽

Serpiginous Choroiditis ◽

Diagnostic Modalities

Abstract Background. To describe changes in the retina/choroid in patients with Serpiginous Choroiditis (SC) by Optical Coherence Tomography Angiography (OCTA) in a multimodal imaging approach. Methods. Prospective, monocentric study of 24 eyes of 12 consenting patients diagnosed with SC, who underwent OCTA, which was analyzed and compared to other methods such as enhanced depth imaging-OCT, fluorescein angiography, indocyanine green angiography, and fundus autofluorescence. Results. The study group consisted of 9 patients with peripapillary SC, 1 macular SC, and 2 atypical cases. All eyes presented an inactive SC confirmed by standard imaging. OCTA demonstrated the lesions tridimensionally in great detail. There was no difference in the angioarchitecture among the 3 forms of SC. A loss of the choriocapillaris/retinal pigment epithelium left a “window-defect”, where the vessels of larger caliber of the choroid became recognizable and their appearance inverted (“white-on-black”). A relationship between the presence of segmentation errors (SE) in the slabs and low visual acuity was established with a one-way ANOVA. Conclusions. OCTA was able to non-invasively assess vascular lesions of the choroid/retina in patients with SC with a high degree of correlation to other diagnostic modalities. Consequent long-term assessments could lead to a better understanding of disease progression.

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