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

Sousa, David Cordeiro; Marques-Neves, Carlos; Kayat, Kim Vieira; Breda, João Barbosa

doi:10.1016/j.ajo.2018.12.026

Cited by 4 publications

(6 citation statements)

References 7 publications

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“…However, the results of these studies do not allow comparison due to use of different devices, scan patterns, and calculation methods. Additionally, several authors note the possible distortion of choriocapillaris images by scanning artifacts or other factors, including neurosensory detachments, and RPE changes [4,7]. The main point of this study was therefore to exclude from analysis regions of the scan where choriocapillaris flow may be affected by overlaid structural changes of RPE or neurosensory retina.…”

Section: Discussionmentioning

confidence: 99%

“…OCTA images may contain false information on hypo-or hyperperfusion due to the number of artifacts. Several authors have reported attenuation of the flow signal in the choriocapillaris under the detached neurosensory retina, RPE detachments, and in cases of irregularity or hyperreflectivity of outer retina [6,7]. All of this suggests that structural changes in overlying neurosensory retina and RPE play an important role in the imaging of blood flow in the choriocapillaris with OCTA.…”

Section: Introductionmentioning

confidence: 99%

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Artifact-Free Evaluation of Choriocapillaris Perfusion in Central Serous Chorioretinopathy

Burnasheva

Kulikov

Maltsev

2020

Vision

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In this study, using optical coherence tomography angiography (OCTA) we evaluated choriocapillaris perfusion in eyes with central serous chorioretinopathy (CSC) after excluding all possible artifacts caused by alterations of neurosensory retina or retinal pigment epithelium (RPE). We have included 22 unilateral acute CSC patients (18 males and four females, 41.8 ± 5.7 years) and 18 healthy subjects (13 males and five females, 40.9 ± 9.7 years). The number of flow voids per 1 mm2 of scan area and percentage of flow signal area was calculated based on choriocapillaris slab of 3 × 3 mm2 OCTA scans after excluding all possible artifacts caused by alterations of neurosensory retina or RPE. The percentage of flow signal area after the exclusion of neurosensory retina and RPE alterations in the eyes of healthy individuals was higher than in CSC eyes (p = 0.006) and fellow unaffected eyes of CSC patients (p = 0.02). The number of flow voids larger than 25,000 µm2 in eyes of healthy individuals was lower than in the CSC eyes (p = 0.0006). There were no statistically significant differences in study parameters between CSC eyes and fellow eyes of CSC patients (p > 0.05). The general decrease of choriocapillaris perfusion in both eyes of CSC patients exists independently of the presence of acute disease or asymptomatic structural RPE changes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Artifact-Free Evaluation of Choriocapillaris Perfusion in Central Serous Chorioretinopathy

Burnasheva

Kulikov

Maltsev

2020

Vision

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“…An increase in the number of choriocapillaris flow voids in the macula in CSC patients has been demonstrated with OCTA. 1,2,4 A spatial association between choriocapillaris loss and pachyvessels has also been revealed. 16 Although local choriocapillaris ischemia has been put forward as a key cause of RPE alteration, it has not been shown at the leakage site in acute CSC.…”

Section: Therapeutic Advances In Ophthalmologymentioning

confidence: 93%

“…typically present in the leakage area and interfere with the OCT scanning beam, compromising reliable quantification of choriocapillaris loss. 4,5 From previous studies, we know that the photoreceptor outer segment (PROS) layer is substantially changed in acute CSC and shows focal thinning above the leakage in the acute stage and irregularity in non-resolving cases. 6,7 This local thinning of PROS above the leakage has been explained by washing out of the photoreceptor outer segments by the leakage.…”

Section: Therapeutic Advances In Ophthalmologymentioning

confidence: 99%

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Photoreceptor outer segment layer thinning as a biomarker in acute central serous chorioretinopathy

et al. 2023

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Background: The photoreceptor outer segment (PROS) layer demonstrates focal thinning above the fluorescein leakage in acute central serous chorioretinopathy (CSC); however, the nature of this phenomenon is not known. Objectives: To study the relationship between the PROS layer and thickness of the outer retinal layers above the fluorescein leakage in newly diagnosed acute CSC. Design: Single-center retrospective study. Methods: All participants received multimodal imaging, including fluorescein angiography and optical coherence tomography. Thickness of PROS, outer nuclear layer (ONL), and ONL-outer plexiform layer (OPL) complex was measured above the leakage and outside the leakage within the area of neurosensory detachment. The number of intraretinal hyperreflective foci of the outer retina was counted. The correlation between PROS thickness and ONL, OPL-ONL complex thickness, and the number of intraretinal hyperreflective foci was calculated. Results: Fifty eyes of 48 patients (38 males and 10 females, 43.8 ± 10.6 years) with a mean symptom duration of 1.4 ± 1.3 months were included. PROS thickness above the fluorescein leakage showed a statistically significant correlation with ONL thickness, OPL-ONL complex thickness, and the number of hyperreflective foci in the outer retina, 0.57, 0.60, and −0.46, respectively ( p < 0.001). Measuring the extent of PROS thinning above the leakage in newly diagnosed CSC allowed to predict self-resolution of subretinal fluid. The greatest linear dimension of PROS thinning showed an area under the receiver operating curve (ROC) curve of 0.98. The cases without PROS thinning had the fastest resolution of subretinal fluid. Conclusion: PROS thinning above the fluorescein leakage in acute CSC is associated with thinning of the outer retinal layers and reveals mild outer retinal atrophy. The absence of PROS thinning predicts faster resolution of CSC.

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Microvascular damage assessed by optical coherence tomography angiography for glaucoma diagnosis: a systematic review of the most discriminative regions

Bekkers

Borren

Ederveen

et al. 2020

Acta Ophthalmologica

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A growing number of studies have reported a link between vascular damage and glaucoma based on optical coherence tomography angiography (OCTA) imaging. This multitude of studies focused on different regions of interest (ROIs) which offers the possibility to draw conclusions on the most discriminative locations to diagnose glaucoma. The objective of this work was to review and analyse the discriminative capacity of vascular density, retrieved from different ROIs, on differentiating healthy subjects from glaucoma patients. PubMed was used to perform a systematic review on the analysis of glaucomatous vascular damage using OCTA. All studies up to 21 April 2019 were considered. The ROIs were analysed by region (macula, optic disc and peripapillary region), layer (superficial and deep capillary plexus, avascular, whole retina, choriocapillaris and choroid) and sector (according to the Garway–Heath map). The area under receiver operator characteristic curve (AUROC) and the statistical difference (p‐value) were used to report the importance of each ROI for diagnosing glaucoma. From 96 screened studies, 43 were eligible for this review. Overall, the peripapillary region showed to be the most discriminative region with the highest mean AUROC (0.80 ± 0.09). An improvement of the AUROC from this region is observed when a sectorial analysis is performed, with the highest AUROCs obtained at the inferior and superior sectors of the superficial capillary plexus in the peripapillary region (0.86 ± 0.03 and 0.87 ± 0.10, respectively). The presented work shows that glaucomatous vascular damage can be assessed using OCTA, and its added value as a complementary feature for glaucoma diagnosis depends on the region of interest. A sectorial analysis of the superficial layer at the peripapillary region is preferable for assessing glaucomatous vascular damage.

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

Cited by 4 publications

References 7 publications

Artifact-Free Evaluation of Choriocapillaris Perfusion in Central Serous Chorioretinopathy

Artifact-Free Evaluation of Choriocapillaris Perfusion in Central Serous Chorioretinopathy

Photoreceptor outer segment layer thinning as a biomarker in acute central serous chorioretinopathy

Microvascular damage assessed by optical coherence tomography angiography for glaucoma diagnosis: a systematic review of the most discriminative regions

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