Evaluation of the choriocapillaris after photodynamic therapy for chronic central serous chorioretinopathy. A review of optical coherence tomography angiography (OCT-A) studies

Christou, Evita Evangelia; Stavrakas, Panagiotis; Kozobolis, Vassilios; Katsanos, Andreas; Georgalas, Ilias; Stefaniotou, Maria

doi:10.1007/s00417-022-05563-3

Cited by 10 publications

(3 citation statements)

References 48 publications

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“…On the other hand, it was recently shown that both swept-source and spectral-domain systems are comparable for choroidal measurements (38). Lastly, it should be noted that our results were produced using a well-known image-processing software and a procedure (binarization) that has been used for similar studies (7,13,14,31,34,39). Theoretically, employing different imaging platforms and processes could have produced different results.…”

Section: Discussionmentioning

confidence: 89%

The Choroid after Half-Dose Photodynamic Therapy in Chronic Central Serous Chorioretinopathy

Christou

Katsanos

Georgalas

et al. 2022

Acta Med. (Hradec Kralove, Czech Repub.)

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Purpose: To characterize choroidal structure and vasculature after half-dose verteporfin photodynamic therapy (hd-vPDT) in eyes with chronic central serous chorioretinopathy using Enhanced Depth Imaging Optical Coherence Tomography (EDI OCT) and Optical Coherence Tomography Angiography (OCT-A). Methods: This prospective case-control study included 10 eyes. Choroid was examined before and at 1 month following hd-vPDT. We measured choroidal thickness (CT) at subfoveal area and at 750 μm nasal and temporal of fovea and thickness of Haller and choriocapillaris/Sattler layers. Whole (WA), luminal (LA) and interstitial area (IA) at EDI-OCT, and perfusion density at OCT-A were analyzed. The unaffected fellow eyes were used for comparisons. Results: Mean CT at subfoveal area and at 750 μm nasal and temporal of fovea, values of Haller and choriocapillaris/Sattler layers and those of WA, LA and IA were reduced, while PD increased at 1 month after hd-vPDT (all p < 0.001). There was a significant (p < 0.05) negative correlation (ρ = −0.658) between PD and post-treatment logMARVA. None of analyzed parameters reached values of unaffected fellow eye. Conclusion: Following hd-vPDT, choroidal thickness with both luminal and interstitial components markedly decreased, while perfusion of choriocapillaris improved.

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Section: Discussionmentioning

confidence: 89%

The Choroid after Half-Dose Photodynamic Therapy in Chronic Central Serous Chorioretinopathy

Christou

Katsanos

Georgalas

et al. 2022

Acta Med. (Hradec Kralove, Czech Repub.)

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“…24 PDT has long been one of the cornerstones of disease therapy, with its action on choroidal vasculature. 25 In recent years, eplerenone has also been extensively studied and discussed as a new pharmacological approach to the disease. 26 In this retrospective study, we analysed with OCTA the VD of the superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris (CC) in patients with CSC treated with vPDT or oral eplerenone.…”

Section: Discussionmentioning

confidence: 99%

OCT-A in chronic central serous chorioretinopathy treated with oral eplerenone and half-fluence photodynamic therapy: A comparative study

Clemente

Cennamo

Montorio

et al. 2022

European Journal of Ophthalmology

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Purpose To evaluate retinal and choriocapillary vessel density (VD) changes in patients with chronic central serous chorioretinopathy (CSC) treated with half-fluence verteporfin photodynamic therapy (vPDT) or eplerenone, using optical coherence tomography angiography (OCTA). Methods Patients affected by CSC and treated with vPDT and eplerenone were retrospectively studied. At baseline and 3 months after each treatment, all patients underwent a complete ophthalmological examination, including an evaluation of best-corrected visual acuity (BCVA), slit-lamp biomicroscopy, fundus examination, fluorescein angiography (FA), indocyanine green angiography (ICGA), spectral-domain optical coherence tomography (SD-OCT) and OCTA. Results Forty-eight eyes of patients with CSC were analysed. Twenty-four eyes were placed in the vPDT group, and 24 eyes formed the eplerenone group. In both groups, OCTA showed a significant improvement in the VD of deep capillary plexus (DCP) and choriocapillaris (CC) after treatments with respect to baseline (p < 0.001), whereas the VD of superficial capillary plexus (SCP) did not show significant differences (p > 0.05). The PDT group demonstrated a statistically significant increase in the VD of DCP and CC with respect to the eplerenone group (DCP p = 0.012; CC p = 0.004). A statistically significant reduction with respect to baseline in subfoveal choroidal thickness (SFCT) (p = 0.001 for vPDT group; p = 0.001 for eplerenone group) and in central foveal thickness (CFT) (p = 0.001 for vPDT group; p = 0.001 for eplerenone group) was also found. The SFCT was significantly thinnest in the PDT group with respect to the eplerenone group (p = 0.021). Conclusion OCTA allowed us to study retinal and choriocapillary vascular changes in patients with CSC treated with vPDT and eplerenone.

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“…Alterations in choroidal blood flow and vascular density can be monitored carefully with OCT angiography, a non-invasive imaging modality. OCT angiography of choriocapillaris in patients with CSCR reveals areas of ischemia, stasis, and hypoperfusion surrounded by regions of greater blood flow [55]. Nicoló et al conducted a study using swept-source OCT angiography to assess vascular flow area in eyes with CSCR.…”

Section: Systemic Associations Of Central Serous Chorioretinopathymentioning

confidence: 99%

Pathomechanisms in central serous chorioretinopathy: A recent update

et al. 2023

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Background Central serous chorioretinopathy (CSCR) is a potentially blinding choroidal disease. Despite decades of research, the pathological mechanisms of CSCR are still poorly understood. In recent years, there has been a strong emphasis on choroidal dysfunction as a primary cause of CSCR. Main Body The concept of the pachychoroid disease spectrum and pachychoroid-driven processes are central to current theories regarding the pathophysiological underpinnings of CSCR. Choroidal hyperpermeability and subsequent leakage of fluid seen in CSCR may be due to several causes. Among them are venous congestion, inflammation, mineralocorticoid receptor activation, systemic factors including hemodynamic changes, obstructive sleep apnea, phosphodiesterase inhibitor use, pregnancy, and genetic predispositions. Congestion of vortex veins that drain blood from the choroid may contribute to the dilation of Haller vessels and cause fluid leakage. Vortex veins exit the eye through the sclera; thus, increased scleral thickness has been proposed to be a factor in venous congestion. Asymmetric vortex vein drainage may similarly result in congestion of the local venous system. Vortex vein anastomoses may overload the venous system and form secondary to venous congestion. Recent studies suggest inflammation and mineralocorticoid activation may factor into the development of CSCR, though more research in these areas is called for. Systemic conditions and genetics may predispose individuals to develop CSCR. Conclusions By striving to understand the molecular and physiological mechanisms of this disease, we can better diagnose and treat CSCR to improve outcomes for patients.

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Evaluation of the choriocapillaris after photodynamic therapy for chronic central serous chorioretinopathy. A review of optical coherence tomography angiography (OCT-A) studies

Cited by 10 publications

References 48 publications

The Choroid after Half-Dose Photodynamic Therapy in Chronic Central Serous Chorioretinopathy

The Choroid after Half-Dose Photodynamic Therapy in Chronic Central Serous Chorioretinopathy

OCT-A in chronic central serous chorioretinopathy treated with oral eplerenone and half-fluence photodynamic therapy: A comparative study

Pathomechanisms in central serous chorioretinopathy: A recent update

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