Optical Coherence Tomography Angiography Quantitative Assessment of Choriocapillaris Blood Flow in Central Serous Chorioretinopathy

doi:10.1016/j.ajo.2018.07.004

American Journal of Ophthalmology

Volume 194, October 2018, Pages 26-34

https://doi.org/10.1016/j.ajo.2018.07.004 Get rights and content

Purpose

To investigate choriocapillaris (CC) blood flow in unaffected fellow eyes of patients with central serous chorioretinopathy (CSC) using quantitative optical coherence tomography angiography (OCTA) analysis.

Design

Case-control study.

Methods

Patients with acute, recurrent, or persistent CSC, along with healthy sex- and age-matched subjects, were included. Objective assessment of CC blood flow was performed using OCTA measurements. Total area of flow signal voids was quantified at baseline, 3 months, and 6 months. Active serous retinal detachment (SRD) was considered as a potential source of false-positive flow impairment; affected eyes were therefore excluded at onset and during follow-up, if this finding was unresolved at the time of measurement.

Results

Sixty patients with CSC and 60 control subjects were included in this study. The total average flow signal void area was significantly higher in the unaffected eyes of CSC patients at baseline (2.70 ± 0.53 mm² vs 2.23 ± 0.43 mm², P < .001). At 3 months, the total average flow signal void area was greater in the affected eyes of CSC patients with resolved SRD compared with unaffected eyes (3.25 ± 0.77 mm² vs 2.67 ± 0.68 mm², P < .001). This total average flow signal void area was larger in unaffected eyes at baseline in recurrent/persistent cases of CSC compared to acute forms (3.74 ± 0.66 mm² vs 2.93 ± 0.69 mm², P = .01).

Conclusions

Vascular abnormalities in CSC involve CC hypoperfusion, suggestive of a primary choroidopathy including ischemic processes. These microvascular flow deficits may constitute one of a number of underlying subclinical changes preceding CSC and other pachychoroid spectrum disorders.

Section snippets

Methods

An international review board approval (French Society of Ophthalmology) was obtained for this study and all the investigations adhered to the tenets of the Declaration of Helsinki. All patients included in this study provided fully informed consent before participation.

This case-control study included naïve consecutive patients with acute, recurrent, or persistent forms of CSC, referred to the Croix-Rousse University Hospital Retinal Center between July 8, 2016 and September 8, 2017. The

Results

Sixty patients with CSC and 60 healthy control subjects were included in this study. Each group consisted of 47 men and 13 women. Mean age was similar in both CSC patients and healthy individuals (42.9 ± 9.1 years vs 42.8 ± 8.8 years; P = .37). Among the CSC patients, 13.3% had a cardiovascular history (arterial hypertension [n = 7] and type 2 diabetes [n = 3]), while 26.7% were exposed to corticosteroid medication. Mean follow-up duration of CSC patients was 4.1 ± 3.1 months. A majority of

Discussion

Optical coherence tomography angiography is a recent noninvasive imaging technique providing high-resolution 3D reconstructions of retinal and choroidal vascular flow patterns. This study took advantage of detailed OCTA microvasculature assessment to analyze and quantify areas of flow reduction at the choriocapillaris level in CSC patients and age-matched healthy individuals. A substantial prospective cohort was achieved, relative to the incidence of CSC in general population,¹¹ as a result of

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Original articleOptical Coherence Tomography Angiography Quantitative Assessment of Choriocapillaris Blood Flow in Central Serous Chorioretinopathy

Purpose

Design

Methods

Results

Conclusions

Section snippets

Methods

Results

Discussion

Prog Retin Eye Res

Ophthalmology

Am J Ophthalmol

Am J Ophthalmol

Ophthalmology

Ophthalmology

Am J Ophthalmol

Am J Ophthalmol

Am J Ophthalmol

Indocyanine green videoangiography of older patients with central serous chorioretinopathy

Retina

Split-spectrum amplitude-decorrelation angiography with optical coherence tomography

Opt Express

OCT angiography compared to fluorescein and indocyanine green angiography in chronic central serous chorioretinopathy

Invest Ophthalmol Vis Sci

Optical coherence tomography angiography in central serous chorioretinopathy

J Ophthalmol

Adaptive local thresholding for detection of nuclei in diversely stained cytology images

Proc International Conf Commun Signal Process

Original article
Optical Coherence Tomography Angiography Quantitative Assessment of Choriocapillaris Blood Flow in Central Serous Chorioretinopathy