Patterns of Choriocapillaris Flow Signal Voids in Central Serous Chorioretinopathy

Matet, Alexandre; Daruich, Alejandra; Hardy, Samuel; Béhar-Cohen, Francine

doi:10.1097/iae.0000000000002271

Cited by 47 publications

(47 citation statements)

References 45 publications

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“…Our patients showed impaired choroidal perfusion at the level of the choriocapillaries after long-term chorioretinopathy despite remission of the disease. [43]; disturbances of choroidal perfusion in their study increased with patient age, duration of CSCR, and disease severity. The choriocapillaries showed thinning and larger choroidal vessel dilation at the affected sites.…”

Section: Discussionmentioning

confidence: 83%

Impairment of visual acuity and retinal morphology following resolved chronic central serous chorioretinopathy

Gawęcki¹,

Jaszczuk-Maciejewska²,

Jurska-Jaśko³

et al. 2019

Preprint

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Purpose Central serous chorioretinopathy(CSCR) is a complex ocular entity that, in its chronic form, can lead to serious visual impairment and morphological damage to the retina. The aim of the current retrospective study was to evaluate the damage present after long-standing but resolved central serous chorioretinopathy and refer it to healthy individuals. Correlations between measurable factors—for example, duration of the disease, baseline retinal morphological parameters, or patient age and/or their degree of impairment—were also assessed. Materials and methods The study group consisted of thirty-two eyes (13 female and 19 male, mean age 49.6 years SD +/- 10.5) with chronic central serous chorioretinopathy ( mean duration 18.9 months SD +/- 15.4) in which complete resolution of subretinal fluid was achieved after subthreshold micropulse laser treatment. Inclusion criterion was a lack of subretinal fluid within the whole area of the central retina scanned by the spectral domain optical coherence tomography. The group was extracted out of 51 cases of chronic CSCR that were treated with that method. They were analyzed according to final best-corrected visual acuity and retinal morphological parameters as measured by spectral optical coherence tomography with angiography option (OCTA). Results were compared with the outcomes of a control group, which consisted of 40 eyes of healthy individuals with full distance visual acuity (0.0 logMAR, 1.0 Snellen) never treated with subthreshold micropulse laser. Statistical analysis included regarding correlation between final visual acuity and final central retinal thickness and retinal and functional parameters prior to treatment. Results Final best-corrected visual acuity after chronic central serous chorioretinopathy was 0.23 logMAR (0.6 Snellen) and central retinal thickness was 39.32 µm smaller than in controls. No correlation was found between final visual acuity and retinal thickness and duration of the disease, patient age, and baseline morphological retinal parameters. OCTA scans revealed impaired choriocapillaries flow signal even following resolution of the disease. Conclusion Chronic central serous chorioretinopathy is a potentially damaging clinical entity that results in serious visual impairment, retinal thinning, and choroidal flow defects. Further research is needed to determine precisely the timepoint of this damage.

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Section: Discussionmentioning

confidence: 83%

Impairment of visual acuity and retinal morphology following resolved chronic central serous chorioretinopathy

Gawęcki¹,

Jaszczuk-Maciejewska²,

Jurska-Jaśko³

et al. 2019

Preprint

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“…The Amsler grid test may be useful in demonstrating metamorphopsy. Hyperopia often develops in the affected eye (19)(20)(21)(22)(23). All cases we included in our study had typical CSC ndings in both FFA and OCT imaging (Fig.…”

Section: Discussionmentioning

confidence: 88%

Central Serous Chorioretinopathy And Selective Serotonin Reuptake Inhibitors

Altun

Atmaca

Icagasioglu³

et al. 2020

Preprint

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Aim: To investigate the relationship between central serous chorioretinopathy (CSC) and selective serotonin reuptake inhibitor (SSRI) antidepressant drugs.Methods: The files of patients diagnosed with CSC who applied to our clinics were analyzed retrospectively. Group 1 was formed from patients who had never used any antidepressant drug. Group 2 and Group 3 were composed of patients who did not stop and stopped using SSRI after the third month, respectively. Ophthalmological examinations, optical coherence tomography and fundus fluorescein angiography images of the patients were analyzed and the groups were compared with each other. Results: Group 1, Group 2 and Group 3 had 122, 8, 12 eyes, respectively. The time for complete resolution of subretinal fluid (SRF) in Group 3 was statistically significantly shorter than Group 1 and Group 2 (p ˂ 0.01). In Group 2, the time for complete resolution of SRF was significantly longer than Group 1 (p ˂ 0.05). Conclusion: SSRI group antidepressant drugs might be an important factor in CSC etiology and prognosis. Discontinuation of these drugs may accelerate subretinal fluid resolution.

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“…32 The choriocapillaris consists of a very thin network of capillaries located very close to the Bruch's membrane. However, it has become a common practice to project the choriocapillaris slab slightly below the anatomically correct slab, 11,12 generating images formed by projected flow rather than in situ flow. This solution attempts to prevent the confounding effect of amplified retinal projections and motion artifacts that might appear in the event of layer segmentation errors.…”

Section: Discussionmentioning

confidence: 99%

“…Erroneous segmentation of the very thin choriocapillaris layer can also produce incorrect visualization, the reason for which some previous studies have preferred to project a slab that is anatomically inaccurate but robust to segmentation errors. 11,12 Motion artifacts due to saccades, ocular tremors or drift add a noise component that is difficult to subtract. Additionally, the choriocapillaris layer is vulnerable to signal loss due to severe shadowing by retinal vessels, large drusen, pupil vignetting, or vitreous floaters.…”

Section: Detecting and Measuring Areas Of Choriocapillaris Low Perfusmentioning

confidence: 99%

Detecting and measuring areas of choriocapillaris low perfusion in intermediate, non-neovascular age-related macular degeneration

et al. 2019

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Age-related macular degeneration (AMD) is a vision-threatening disease that affects the outer retina and choroid of elderly adults. Because photoreceptors are found in the outer retina and rely primarily on the trophic support of the underlying choriocapillaris, imaging of flow or lack thereof in choriocapillaris by optical coherence tomography angiography (OCTA) has great clinical potential in AMD assessment. We introduce a metric using OCTA, named "focal perfusion loss" (FPL) to describe the effects of age and non-neovascular AMD on choriocapillaris flow. Because OCTA imaging of choriocapillaris is vulnerable to artifacts-namely motion, projections, segmentation errors, and shadows-they are removed by postprocessing software. The shadow detection software is a machine learning algorithm recently developed for the evaluation of the retinal circulation and here adapted for choriocapillaris analysis. It aims to exclude areas with unreliable flow signal due to blocking of the OCT beam by objects anterior to the choriocapillaris (e.g., drusen, retinal vessels, vitreous floaters, and iris). We found that both the FPL and the capillary density were able to detect changes in the choriocapillaris of AMD and healthy age-matched subjects with respect to young controls. The dominant cause of shadowing in AMD is drusen, and the shadow exclusion algorithm helps determine which areas under drusen retain sufficient signal for perfusion evaluation and which areas must be excluded. Such analysis allowed us to determine unambiguously that choriocapillaris density under drusen is indeed reduced. © The Authors. Published by SPIE under a Creative Commons Attribution 4.0 Unported License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

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Patterns of Choriocapillaris Flow Signal Voids in Central Serous Chorioretinopathy

Abstract: Choriocapillaris flow voids colocalize with choriocapillaris thinning and deep choroidal vessel dilation in CSCR eyes. Age and CSCR severity influence choriocapillaris flow, a key contributor to CSCR pathophysiology and clinical expression.

Cited by 47 publications

References 45 publications

Impairment of visual acuity and retinal morphology following resolved chronic central serous chorioretinopathy

Impairment of visual acuity and retinal morphology following resolved chronic central serous chorioretinopathy

Central Serous Chorioretinopathy And Selective Serotonin Reuptake Inhibitors

Detecting and measuring areas of choriocapillaris low perfusion in intermediate, non-neovascular age-related macular degeneration

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