Swept-Source OCT Angiography of Serpiginous Choroiditis

Pakzad-Vaezi, Kaivon; Khaksari, Kosar; Chu, Zhongdi; Gelder, Russell N. Van; Wang, Ke; Pepple, Kathryn L.

doi:10.1016/j.oret.2017.11.001

Cited by 33 publications

(23 citation statements)

References 26 publications

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“…Recently, optical coherence tomography (OCT) and OCT based angiography (OCTA) (9,10) have been introduced into clinical ophthalmology (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). OCTA is a non-invasive, safe, fast, and cost-effective technology that extracts the intrinsic signals due to moving particles, such as red blood cells, in functional vessels to achieve an in vivo angiogram.…”

Section: Introductionmentioning

confidence: 99%

Quantifying choriocapillaris flow deficits using global and localized thresholding methods: a correlation study

Chu

Zhang

Zhou

et al. 2018

Quant. Imaging Med. Surg

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Background: To investigate the correlation and agreement of two previously published choriocapillaris (CC) quantification methods using a normal database with swept-source optical coherence tomography angiography (SS-OCTA).Methods: Normal adult subjects from all age groups imaged by SS-OCTA were used in this study. Each subject was imaged with 3 mm × 3 mm and 6 mm × 6 mm scan patterns centered on fovea, upon which en face CC images were generated by segmenting volumetric OCTA data. After signal compensation and removal of projection artifacts and noise, CC images were analyzed to identify flow deficits (FD) using two published methods. The first method utilized standard deviation from a young normal database (SD method) as the global thresholding while the second method utilized fuzzy C-means algorithm (FCM method) with local thresholding. Both methods segmented FDs from CC images and quantified FD density (FDD) and mean FD size (MFDS). In each 3 mm × 3 mm scan, three regions were quantified: a 1 mm circle (C 1 ), a 1.5 mm rim (R 1.5 ) and a 2.5 mm circle (C 2.5 ). In each 6 mm × 6 mm scan, five regions were quantified: C 1 , R 1.5 , C 2.5 , a 2.5 mm rim (R 2.5 ) and a 5 mm circle (C 5 ). Spearman correlation and Bland-Altman plot analyses were conducted to compare the two methods.Results: Data obtained from 164 normal subjects (age: 56±19, 59% females) were used in this study. Strong correlations were observed between the two methods in all comparisons (r: 0.78-0.94, all P<0.0001). Overall MFDS provided higher or comparable correlation coefficients (r) compared to FDD. We have also observedstronger correlations in the central macula compared to parafoveal and perifoveal regions for both FDD and MFDS. In regions of C 1 , R 1.5 and C 2.5 , 6 mm × 6 mm scans resulted in better agreement (smaller mean bias, similar or tighter limit of agreement) between the two methods for both FDD and MFDS compared to 3 mm × 3 mm scans.Conclusions: There are strong correlations and satisfactory agreement between SD method and FCM method. SD method requires the reference to a normal database for CC quantification while FCM does not. Both methods could be used for the analysis of CC FDs in clinical settings depending on specific study designs such as the availability of a normal database.

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Section: Introductionmentioning

confidence: 99%

Quantifying choriocapillaris flow deficits using global and localized thresholding methods: a correlation study

Chu

Zhang

Zhou

et al. 2018

Quant. Imaging Med. Surg

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“…However, the absence of shadowing in the enface slabs suggest that these are areas of true choroidal ischemia rather than inflammatory edema. [ 10 ] In inactive or healed lesions, there is still some flow visible in the larger choroidal vessels and these areas are presumed to be devoid of choriocapillaris with reduced vessel density. The objective quantification of this flow void or the corresponding flow density has the potential to become a biomarker for these diseases involving the choriocapillaris.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of change in the vascular density of choriocapillaris on optical coherence tomography angiography in eyes with serpiginous choroiditis

Shah

Rao

Verma

et al. 2020

Indian J Ophthalmol

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Purpose: Serpiginous choroiditis (SC) is primarily an inflammation of choriocapillaris leading to nonperfusion. A quantitative assessment of choriocapillaris perfusion can be done by measuring the flow-density by OCT-Angiography (OCTA). This study measures a change in the flow-density of choriocapillaris with the resolution of inflammation. Methods: The OCTA images of a choriocapillaris slab of 30 eyes with active SC were subjected to binarization and vessel density was measured at baseline and final visits and compared. Results: Upon comparing the vessel density of the affected areas by OCTA of choriocapillaris-slab at baseline and final visits, there was statistically significant ( P < 0.0001) improvement after the resolution of inflammation. The vessel density of a demarcated normal area was significantly higher when compared to that of lesions at baseline ( P < 0.0001) and final visit ( P < 0.0001). Conclusion: OCTA is a useful tool to assess reduction in the inflammatory activity on treatment in SC. This study shows that with treatment the perfusion of choriocapillaris improves; however, it remains lower than normal.

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“…Inactive patients demonstrated partial reappearance of choriocapillaris at lesion margins with absence of outer retina, RPE, and choriocapillaris at inactive geographic regions [ 5 ]. Another case series of active and inactive SC lesions demonstrated disproportionate involvement of choriocapillaris compared to overlying RPE and deep retinal vasculature, suggesting that the choriocapillaris may be the primary pathologic site in SC [ 6 ]. In our patient, dropout of deep retinal vasculature was seen beyond lesion borders identified on photography and fluorescein angiography, indicating subclinical inflammation in areas not previously identifiable.…”

Section: Discussionmentioning

confidence: 99%

OCT Angiography and En Face OCT Reflectance Aid in Monitoring Subclinical Inflammation in Serpiginous Choroidopathy

Wilkins

Romo

Chui

et al. 2020

Case Reports in Ophthalmological Medicine

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Introduction. We present a case of serpiginous choroidopathy (SC) with novel OCTA and en face OCT reflectance findings which help identify subclinical disease progression. Case Presentation. En face OCT reflectance images demonstrated outer retinal tubules (ORT) at the serpiginous lesion margins of affected and unaffected retina on multimodal imaging. OCTA findings demonstrate variable dropout of choriocapillaris in “normal” retina beyond lesion borders which was not visible on standard imaging and which demonstrated a clear transition zone beyond the ORT. Discussion. This is the first report of choriocapillaris atrophy identified on OCTA not identified on traditional multimodal imaging in serpiginous choroidopathy. Damage to vasculature only visible with OCTA may help characterize the distribution of inflammation, aiding in monitoring of suppression not illustrated by traditional imaging and which may threaten the central macula. ORT in SC suggest death and reorganization of outer segments from dysfunction of the choriocapillaris and RPE, as well as serve to demarcate the area of chronic or old inflammation, supporting the hypothesis that the choriocapillaris is the primary site of inflammation in SC. Based on these findings, we recommend OCTA on all patients with serpiginous choroidopathy to monitor underlying state of inflammation and help determine immunosuppressive threshold.

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Swept-Source OCT Angiography of Serpiginous Choroiditis

Cited by 33 publications

References 26 publications

Quantifying choriocapillaris flow deficits using global and localized thresholding methods: a correlation study

Quantifying choriocapillaris flow deficits using global and localized thresholding methods: a correlation study

Evaluation of change in the vascular density of choriocapillaris on optical coherence tomography angiography in eyes with serpiginous choroiditis

OCT Angiography and En Face OCT Reflectance Aid in Monitoring Subclinical Inflammation in Serpiginous Choroidopathy

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