scholarly journals Central Serous Chorioretinopathy in a Myopic Patient with Pachychoroid

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.

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

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
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.

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

2017 ◽  
Vol 102 (4) ◽  
pp. 473-478 ◽  
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.

Multiple Evanescent White Dot Syndrome (MEWDS) Associated with Progression of Lacquer Cracks in High Myopia

2021 ◽  
Author(s):  
Ariel Yuhan Ong ◽  
Johannes Birtel ◽  
Peter Charbel Issa
Keyword(s):  
High Myopia ◽  
Indocyanine Green Angiography ◽  
Pigment Epithelium ◽  
Fundus Autofluorescence ◽  
Retinal Pigment ◽  
Fundus Photography ◽  
Disease Course ◽  
Imaging Findings ◽  
Membrane Complex ◽  
White Dot Syndrome

Abstract Purpose To report a case of multiple evanescent white dot syndrome (MEWDS) associated with acute progression of lacquer cracks in high myopia. Case Report A 41-year-old female patient with high myopia developed typical signs, symptoms, and disease course of MEWDS in her right eye. At the same time, the same eye showed progression of lacquer cracks when compared to images taken 2 months prior. Retinal imaging findings characteristic of MEWDS were most obvious on fundus autofluorescence, whereas alterations on color fundus photography, optical coherence tomography, fluorescein, and indocyanine green angiography were very mild, probably because of the myopia-related fundus pathology. Conclusion We present a case of MEWDS co-occurring with acute progression of lacquer cracks. This adds to the increasing evidence that impaired integrity of the retinal pigment epithelium-Bruchʼs membrane complex may be a factor in causing MEWDS, possibly by exposing otherwise isolated antigens. The anatomy in a highly myopic eye may make it challenging to diagnose MEWDS-associated fundus changes.

Cone dystrophy with supernormal rod responses: A rare KCNV2 gene variant

2021 ◽  
pp. 112067212110000
Author(s):  
João Esteves-Leandro ◽  
Sónia Torres-Costa ◽  
Sérgio Estrela-Silva ◽  
Renato Santos-Silva ◽  
Elisete Brandão ◽  
...  
Keyword(s):  
Rare Variant ◽  
Pigment Epithelium ◽  
Fundus Autofluorescence ◽  
Retinal Pigment ◽  
Pattern Electroretinogram ◽  
Fundus Photography ◽  
Cone Dystrophy ◽  
Ophthalmological Examination ◽  
Full Field ◽  
Visual Acuity Loss

Purpose: To describe the clinical, electrophysiological, and genetic findings of three Portuguese families with a rare variant in the KCNV2 gene resulting in “cone dystrophy with supernormal rod responses” (CDSRR). Methods: Retrospective clinical revision of five individuals from three unrelated families with CDSRR. Ophthalmological examination was described in all patients and included color vision testing, fundus photography, fundus autofluorescence (FAF) imaging, spectral domain-optical coherence tomography (SD-OCT), pattern electroretinogram (ERG), and full-field ERG. The mutational screening of the KCNV2 gene was performed with Sanger and Next Generation Sequencing. Results: All patients showed childhood-onset photophobia and progressive visual acuity loss with varying degrees of severity. In multimodal imaging, various degrees of retinal pigment epithelium disturbances and outer retinal atrophy, which tend to be worst with advancing age, were observed. Molecular screening identified a rare presumed truncating variant (p.Glu209Ter) in homozygosity in two families and in compound heterozygosity in a third family. Three patients showed ERG changes characteristic of CDSRR, however, two patients presented with incomplete electrophysiological features of the disease. Conclusion: A rare variant in the KCNV2 gene was identified in five patients from three Portuguese families. This variant often leads to a severe and progressive form of retinopathy. Considerable variability in the ERG responses among patients with this KCNV2 variant was observed.

Multimodal imaging of chorioretinal folds induced by orbital vascular malformation in two cases

2020 ◽  
pp. 112067212095758
Author(s):  
Ahmet Kaan Gündüz ◽  
Carol L Shields ◽  
Şükran Bekdemir ◽  
Jerry A Shields
Keyword(s):  
Functional Status ◽  
Multimodal Imaging ◽  
Pigment Epithelium ◽  
Fundus Autofluorescence ◽  
Retinal Pigment ◽  
Late Phase ◽  
Vascular Tumor ◽  
Fundus Photography ◽  
Swept Source ◽  
Chorioretinal Folds

Purpose: To investigate the alterations in the retinal pigment epithelium (RPE) in the crest and trough portions of chorioretinal folds (CRFs) induced by an orbital vascular tumor. Methods: Review of multimodal imaging in two eyes of two patients with globe compression and CRFs from an orbital vascular tumor. Results: Fundus photography demonstrated obliquely extending CRFs with alternating hyperpigmented and hypopigmented linear alterations in both eyes. Fundus autofluorescence (AF) imaging showed obliquely oriented hypoAF lines, incompletely alternating with hyperAF lines. In Case 1, the hyperAF lines had interspersed hypoAF segments and Case 2 had peripapillary mottling of AF. Fluorescein angiography (FA) showed alternating hyper and hypofluorescent lines in the late phase in Case 1. Optical coherence tomography (OCT) documented relative thinning of RPE at the folded crests in Case 1 and preservation of RPE in Case 2. Swept-source OCT angiography (SS-OCTA) demonstrated oblique hyporeflective lines in the outer retina and choriocapillaris layers in Case 2. These findings suggest that the crest of a CRF represents thinned or rarified RPE with hypoAF, transmission hyperfluorescence (FA), partially attenuated RPE layer (OCT), and isoreflectivity (SS-OCTA) while the trough represents compressed RPE with irregular hyperAF, transmission hypofluorescence (FA), thickened RPE layer (OCT), and hyporeflectivity (SS-OCTA). Conclusion: The anatomic and functional status of the RPE in CRFs based on multimodal imaging reveals normal to attenuated RPE with hypofunctionality at the fold crest and compacted, thickened RPE at the trough with segmental functional impairment on AF imaging. Anatomic information regarding CRFs is evident on OCT, FA, and SS-OCTA while the functional status is depicted on AF.

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

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.

scholarly journals Acute Zonal Occult Outer Retinopathy (AZOOR) Results from a Clinicopathological Mechanism Different from Choriocapillaritis Diseases: A Multimodal Imaging Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1184
Author(s):  
Carl P. Herbort ◽  
Ilir Arapi ◽  
Ioannis Papasavvas ◽  
Alessandro Mantovani ◽  
Bruno Jeannin
Keyword(s):  
Visual Field ◽  
Multimodal Imaging ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Immunosuppressive Treatment ◽  
Case Series ◽  
Fundus Photography ◽  
Ganglion Cell Complex ◽  
Ophthalmological Examination ◽  
Sequence Of Events

Background and aim: AZOOR is a rare disease characterized by loss of zones of outer retinal function, first described by J Donald Gass in 1993. Symptoms include acute onset photopsias and subjective visual field losses. The syndrome is characterized by a normal fundus appearance, scotomas and electroretinographic changes pointing towards outer retinal dysfunction. Evolution, response to immunosuppressive treatment and outcome are difficult to predict. The aim of this small case series was to identify the morphological changes and sequence of events in AZOOR thanks to multimodal imaging. Methods: Charts of AZOOR patients seen in the Centre for Ophthalmic Specialized care (COS, Lausanne, Switzerland) were analyzed by multimodal imaging including fundus photography, fluorescein angiography (FA), indocyanine green angiography (ICGA), blue light fundus autofluorescence (BL-FAF) and spectral domain optical coherence tomography (SD-OCT) in addition to a complete ophthalmological examination including visual field testing and microperimetry, as well as OCT angiography (OCT-A) and ganglion-cell complex analysis when available. Cases and Results: Three AZOOR patients with a mean follow-up of 47 ± 25.5 months were included following the clinical definitions laid down by J Donald Gass. The primary damage was identified at the level of the photoreceptor outer segments with an intact choriocapillaris and retinal pigment epithelium (RPE) layer, these structures being only secondarily involved with progression of the disease. Conclusion: Although AZOOR has often been included within white dot syndromes, some of which are now known to be choriocapillaris diseases (choriocapillaritis entities), our findings clearly commend to differentiate AZOOR from entities such as MEWDS (Multiple evanescent white dot syndrome), APMPPE (Acute Posterior Multifocal Placoid Pigment Epitheliopathy), MFC (Multifocal Choroiditis) and others, as the damage to photoreceptors is primary in AZOOR (a retinopathy) and secondary in choriocapillaritis (a choriocapillaropathy).

scholarly journals Morphometric and topograpical analysis of retinal abnormalities in central serous chorioretinopathy

2020 ◽  
pp. 48-52
Author(s):  
D. S. Maltsev ◽  
E. Yu. Malakhova ◽  
A. N. Kulikov ◽  
A. A. Kazak
Keyword(s):  
Retinal Pigment Epithelium ◽  
Central Serous Chorioretinopathy ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Cumulative Distribution ◽  
Ophthalmological Examination ◽  
Topographic Analysis ◽  
Quantitative Characteristics ◽  
Detachment Zone ◽  
Acute Central Serous Chorioretinopathy

Objective: Quantitative morphometric and topographic analysis of specific changes of the retina in patients with the acute central serous chorioretinopathy (CSC) based on annotated tomograms.Methods: 39 patients with the acute CSC (44 eyes – 45 scans) were examined. A complex ophthalmological examination was carried out including 3D optical coherence tomography of maculae. The data was uploaded into CVAT. Three classes of pathological changes were differentiated: 1) retinal neuroepi‑ thelium detachment; 2) retinal pigment epithelium alteration; 3) percolation zones. The analysis of topographical localization of changes and their morphological relations were assessed with a programming language Python.Results: A moderate trend towards vertical asymmetry of the neuroepithelial detachment zone with an excess of cumulative distribution in the lower part of the macula was revealed. Retinal pigment epithelium alteration sites and percolation zones demonstrated a relative peak of representation in the upper nasal part of the macula. In 69.9% and 80% of cases, respectively, abnormalities of retinal pigment epithelium and percolation zones were localized within the limits of neuroepithelial detachment. Direct correlation between the area of neuroepithelial detachment and the area of percolation zones; the area of percolation zones and the area of retinal pigment epithelium alteration; the area of neuroepithelial detachment and the area of retinal pigment epithelium alteration.Conclusions: Percolation zones and abnormalities of retinal pigment epithelium demonstrate similar trends in topo‑ graphical localization and quantitative characteristics and are related to the area of neuroepithelial detachment in CSC. Thus, the number of retinal pigment epithelium abnormalities can serve as an indicator of disease severity.

Chronic Central Serous Chorioretinopathy; Signs, Diagnosis and Treatment

2020 ◽  
pp. 104-111
Keyword(s):  
Central Serous Chorioretinopathy ◽  
Pigment Epithelium ◽  
Fundus Autofluorescence ◽  
Retinal Pigment ◽  
Subretinal Fluid ◽  
Fluid Accumulation ◽  
Fundus Fluorescein Angiography ◽  
Blurred Vision ◽  
Chronic Central Serous Chorioretinopathy

Central serous chorioretinopathy (CSCR) is a maculopathy characterized by the separation of the neurosensory layer as a result of fluid accumulation between the retinal pigment epithelium (RPE) and the photoreceptor layer. Classically it is classified as acute and chronic forms. When the disease lasts longer than 4-6 months, it is called a chronic form and comprises 15% of all CSCR cases. Although the exact etiology is unknown; studies emphasize changes in choroidal circulation causing choroidal ischemia and vascular hyperpermeability as well as subretinal fluid accumulation due to deterioration pump function of RPEs. Subretinal fluid accumulation can lead to photoreceptor dysfunction and loss of vision. Classical findings in patients are a decrease in visual acuity, blurred vision, metamorphopsia, micropsia, disturbance in color vision and dark adaptation, and scotomas. Diagnosis and follow-up depend on fundoscopy as well as imaging. Optical coherent tomography is the primary method. Fundus autofluorescence (FAF) is useful in defining RPE changes noninvasively. Fundus fluorescein angiography (FFA) shows the source of leakage. In recurrent, unresolved and chronic cases, OCT, FAF, FFA, and indocyanine green angiography can be used all together to manage the disease, to follow-up its extension, and to diagnose possible neovascular as well as polypoidal component. For the treatment of chronic CSCR patients, besides medical treatments such as carbonic anhydrase inhibitors, mineralocorticoid receptor, and glucocorticoid antagonists and intravitreal vascular endothelial growth factor antagonist (Anti-VEGF) injections, half-dose photodynamic therapy and subthreshold micropulse laser treatment are used. Prospective, controlled trials with large series for the treatment of chronic CSCR warranted.

scholarly journals Fundus Autofluorescence and Spectral Domain OCT in Central Serous Chorioretinopathy

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Luiz Roisman ◽  
Daniel Lavinsky ◽  
Fernanda Magalhaes ◽  
Fabio Bom Aggio ◽  
Nilva Moraes ◽  
...  
Keyword(s):  
Fluorescein Angiography ◽  
Central Serous Chorioretinopathy ◽  
Near Infrared ◽  
Pigment Epithelium ◽  
Fundus Autofluorescence ◽  
Subretinal Fluid ◽  
Spectral Domain ◽  
Fundus Photography ◽  
Cross Sectional ◽  
Spectral Domain Oct

Background. To describe the standard autofluorescence (FAF), the near infrared autofluorescence (NIA) and optical coherence tomography (OCT) patterns in central serous chorioretinopathy, correlating them with fluorescein angiography.Methods. Cross-sectional observational study, in which patients with at least seven months of CSC underwent ophthalmologic examination, fundus photography, FAF, NIA, fluorescein angiography (FA), and spectral-domain OCT.Results. Seventeen eyes of thirteen patients were included. The presentation features were a mottled hyperFAF in the detached area and areas with pigment mottling. NIA images showed areas of hyperNIA similar to FAF and localized areas of hypoNIA, which correlated with the points of leakage in the FA. OCT showed pigment epithelium detachment at the location of these hypoNIA spots.Discussion. FAF showed increased presence of fluorophores in the area of retinal detachment, which is believed to appear secondary to lipofuscin accumulation in the RPE or the presence of debris in the subretinal fluid. NIA has been related to the choroidal melanin content and there were areas of both increased and decreased NIA, which could be explained by damage ahead the retina, basically RPE and choroid. These findings, along with the PEDs found in the areas of hypoNIA, support the notion of a primary choroidal disease in CSC.

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