scholarly journals Optical Coherence Tomography Parameters as Predictors of Treatment Response to Eplerenone in Central Serous Chorioretinopathy

2019 ◽  
Vol 8 (9) ◽  
pp. 1271 ◽  
Author(s):  
Enrico Borrelli ◽  
Biancamaria Zuccaro ◽  
Ilaria Zucchiatti ◽  
Mariacristina Parravano ◽  
Lea Querques ◽  
...  

Purpose: To present data on clinical response to eplerenone over a 1-year period in patients with central serous chorioretinopathy (CSC), and to evaluate optical coherence tomography (OCT) variables as predictors of treatment response at 3- and 12-month follow-up visits. Methods: Patients with acute or chronic CSC treated with eplerenone were retrospectively included. Clinical and imaging characteristics were recorded at baseline and at the 3-month and 12-month follow-up visits. Changes from baseline in quantitative measurements were calculated at each follow-up. Logistic regression analysis was computed to correlate clinical and OCT parameters at baseline with response to treatment at 3 and 12 months of follow-up. Results: A total of 50 eyes of 50 patients were included in the study. Mean ± SD best corrected visual acuity (BCVA) was 0.20 ± 0.14 Logarithm of the Minimum Angle of Resolution (LogMAR) at baseline and significantly improved at both the 3-month (0.12 ± 0.13 LogMAR, p < 0.0001) and 12-month (0.10 ± 0.12 LogMAR, p < 0.0001) follow-up visits. At the 3-month follow-up visit, 25 out of 50 eyes (50.0%) demonstrated macular complete subretinal fluid (SRF) resolution, while 13 eyes (26.0%) showed macular partial SRF resolution, and 12 eyes (24%) had neither partial nor complete macular SRF resolution. Among those patients with macular partial or complete SRF resolution at 3 months and thus not shifted to photodynamic therapy, 36 out of 38 cases had macular complete SRF resolution at the 12-month follow-up visit. There was a significant change from baseline at both follow-up visits in all anatomical OCT parameters (except for reduction in choroidal thickness that did not reach the statistical significance at the 12-month follow-up visit). Several OCT parameters at baseline were independently significant predictors for macular subretinal fluid complete resolution at 3 months, including (i) a thicker subfoveal choroidal thickness; (ii) a smaller subretinal fluid maximum diameter; (iii) a lower number of serous pigment epithelium detachments; and (iv) a lower number of intraretinal hyperreflective foci. Conclusion: Treatment with eplerenone in CSC patients is confirmed to be beneficial for both anatomical and functional outcomes. We identified attractive OCT metrics that could potentially be used as a tool to select patients who might mainly benefit from this treatment.

2021 ◽  
Vol 2 (1) ◽  
pp. 31-36
Author(s):  
Ragai Magdy Hatata ◽  
◽  
Sherin Hassan Sadek ◽  

AIM: To study the changes in choroidal thickness in central serous chorioretinopathy (CSCR) over a 3mo follow-up using spectral domain optical coherence tomography (SD-OCT). METHODS: This prospective study included 60 eyes, both eyes of 20 patients (mean age: 33.65±5.24y) with classic acute unilateral central serous chorioretinopathy and normal fellow eye and 20 eyes as healthy controls. Fluorescein angiography and OCT were done. The subfoveal choroidal thickness (SFCT), central macular thickness (CMT), 1000 μm temporal and nasal to the centre of the fovea and the subretinal fluid were measured. RESULTS: There was a statistically significant difference in SFCT among the three groups at the three different locations. SFCT in eyes with CSCR (372.40±34.39 μm) was significantly greater than that in each of the unaffected fellow eyes (302.10±8.9 μm) and control eyes (279.80±14.49 μm) at the base line and after 3mo follow-up. The mean CMT in CSCR was 317±141.86 μm, with a statistically significant positive correlation between SFCT and CMT. CONCLUSION: The increase in the choroidal thickness at different locations as well as hyper-dilated and hyper-permeable vessels known as “pachychoroid” seems to play an important role in a broad spectrum of diseases that includes central serous chorioretinopathy.


2020 ◽  
Vol 12 ◽  
pp. 251584141989982
Author(s):  
Durgasri Jaisankar ◽  
Meenakshi Kumar ◽  
Pukhraj Rishi ◽  
Sumeer Singh ◽  
Rajiv Raman

Purpose: To evaluate affected choroidal regions and corresponding retinal changes in acute and recurrent central serous chorioretinopathy using swept-source optical coherence tomography. Methods: The foveal and subfoveal choroidal thicknesses were measured with swept-source optical coherence tomography. The retina was divided into five zones on the swept-source optical coherence tomography image based on baseline choroidal thickness being <100, 100–199, 200–299, 300–399 and ⩾400 μm. The retinal and choroidal thicknesses in the same five regions were evaluated during follow-up. The measurements were then compared between baseline (when central serous chorioretinopathy was active) and follow-up (after complete resolution of disease). Results: At baseline, in the acute group, the mean outer retinal layer thickness was significantly higher in areas with thicker choroid and lower in areas with thinner choroid. No such change was noticed in the recurrent group. In the acute group, the overall retinal thickness from baseline to follow-up decreased from 269.84 to 251.9 µm, ganglion cell layer thickness decreased from 107.14 to 101.28 µm, retinal nerve fibre layer thickness decreased from 56.96 to 49.33 µm, and no significant difference was noted in choroidal thickness. In the recurrent group, choroidal thickness significantly increased from 254.58 to 262.55 µm and ganglion cell layer decreased from 103.43 to 94.01 µm. No significant difference was noted in overall retina and retinal nerve fibre layer. Reduction in choroidal and retinal layer thicknesses was better in eyes which underwent laser treatment than the observation group. Conclusion: Swept-source optical coherence tomography might serve as an important non-invasive tool for both evaluating the extent of pathology and to predict the recurrence rate.


2021 ◽  
Vol 8 ◽  
Author(s):  
Zheng Zhang ◽  
Yue Qi ◽  
Wenbin Wei ◽  
Zi-Bing Jin ◽  
Wen Wang ◽  
...  

Purpose: This work aimed to study the effect of posterior scleral reinforcement (PSR) on choroidal thickness (CT) and blood flow.Methods: This study included 25 eyes of 24 patients with high myopia ( ≤ -6.0 dioptres or axial length ≥ 26.0 mm) who underwent PSR surgery. All patients completed the 1-month follow-up visit. Myopic macular degeneration (MMD) was graded according to the International Meta-Analysis for Pathologic Myopia (META-PM) classification based on color fundus photographs. Swept-source optical coherence tomography angiography (SSOCTA) was performed to investigate CT, choroidal perfusion area (CPA), and choriocapillaris perfusion area (CCPA) change following PSR surgery.Results: The distribution of MMD categories was 9 (36.0%) in category 1, 10 (40.0%) in category 2, and 6 (24.0%) in category 3 or 4. MMD severity was strongly correlated with CT (all P &lt; 0.01) and CPA (all P &lt; 0.04). Postoperative CT at each sector increased significantly at 1 week's follow-up, compared to preoperative measures (all P &lt; 0.05). Postoperative CPA at subfoveal, superior, inferior, and nasal sectors also increased significantly 1 week after PSR surgery (all P &lt; 0.05). Moreover, the increased CT, CPA, and CCPA remain after PSR surgery at 1 month's follow-up, but the difference was not statistically significant.Conclusions: We demonstrated that the CT and choroidal blood flow increased significantly in patients with high myopia who underwent PSR surgery in a short period of time. In addition, the CT and CPA were independently associated with MMD. However, whether the transient improvement of the choroidal circulation could prevent long-term progression of high myopia warrants further study in the future.


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.


2012 ◽  
Vol 142 (5) ◽  
pp. S-110 ◽  
Author(s):  
Yuankai Tao ◽  
Osman O. Ahsen ◽  
Tsung-Han Tsai ◽  
Chao Zhou ◽  
Hsiang-Chieh Lee ◽  
...  

2020 ◽  
pp. 112067212095760
Author(s):  
Alper Bilgic ◽  
Francesc March de Ribot ◽  
Pooja Ghia ◽  
Anand Sudhalkar ◽  
Laurent Kodjikian ◽  
...  

Background: To determine the association between hyperreflective area identified on the reference image (en-face image) in spectral domain optical coherence tomography (SD-OCT) scan and the leak on fluorescein angiography in patients with acute treatment naive central serous chorioretinopathy (CSCR). Methods: Retrospective, observational chart review. The reference image (en-face) image on SD OCT raster scan was examined for the presence of a hyperreflective spot and an attempt was made to correlate its location on the actual leak seen on FFA using anatomical landmarks as reference. Follow up was 6 months after CSCR resolution. Appropriate statistical analysis was made. Results: Sixty-two patients (65 eyes; 49 males) with CSCR were identified of which 62/65 eyes (95.38%) showed the said correlation. The mean age was 31.24 years. The mean follow-up was 17.25 months. The mean BCVA at baseline was 0.28 logMAR. The mean final BCVA was 0.08. The hyperreflective spot noted on the infrared (reference) image correlated the most with the classic ink-blot leakage as well as the minimally enhancing/ill-defined leakage pattern. In 37/41 eyes, the area of hyperreflectivitiy correlated with the pigment epithelial detachment. The hyperreflective spot resolved in most patients who received photodynamic therapy but persisted in most patients who received eplerenone therapy. Persistent hyperreflectivity after subretinal fluid resolution appeared to correlate with persistent metamorphopsia and reduced contrast sensitivity in eyes with no subretinal fluid. Conclusion: We demonstrate an interesting correlation between the area of leak and the OCT reference image (en face) used to determine the level of the scan. Synopsis The study looks at the potential applicability of a correlation between leaking areas on fundus fluorescein angiography and a hyperreflective area on the infrared image in optical coherence tomography (OCT) in patients with central serous chorioretinopathy (CSCR).


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