scholarly journals Influence of Retinal Microsecond Pulse Laser Treatment in Central Serous Chorioretinopathy: A Short-Term Optical Coherence Tomography Angiography Study

2021 ◽  
Vol 10 (11) ◽  
pp. 2418
Author(s):  
Michelle Prasuhn ◽  
Yoko Miura ◽  
Aysegül Tura ◽  
Felix Rommel ◽  
Vinodh Kakkassery ◽  
...  

Background: Central serous chorioretinopathy (CSC) is a common macular condition characterized by detachment of the neuroretina and is a frequent cause of central vision loss in adults. Among the various therapeutic strategies, subthreshold microsecond pulsed laser (SML) treatment has become a useful option. Despite the suggested involvement of choroidal circulatory disturbances in CSC, the effects of this treatment on macular microperfusion have not been fully evaluated yet. Herein, we report the impact of SML on retinal and choroidal microvascular flow using non-invasive optical coherence tomography (OCT) angiography (OCTA). Methods: In this study, CSC patients with persistent subretinal fluid (SRF) with or without secondary choroidal neovascularization (CNV) were included (referred to as the pachychoroid neovasculopathy (PNV) group and the CSC group, respectively). SML was conducted using a yellow (577 nm) laser with a duty cycle of 10%, spot size of 200 µm and duration of 200 ms. Best corrected visual acuity (BCVA) as well as OCT and OCTA images were evaluated at baseline and 4 weeks after SML. OCTA parameters of interest included full retinal perfusion (FRP), choriocapillaris perfusion (CCP), Sattler’s layer perfusion (SLP), and Haller’s layer perfusion (HLP), which were evaluated longitudinally and compared to unaffected fellow eyes. Results: 27 affected eyes and 17 fellow eyes from 27 patients were included. Before treatment, central retinal thickness (CRT) and subfoveal choroidal thickness (SFCT) of affected eyes were significantly larger than in fellow eyes. Four weeks after SML, CRT decreased significantly, whereas perfusion parameters did not change. In subgroup analyses, the CSC group showed a significant decrease in SFCT, whereas the PNV group did not despite the decrease in CRT. Conclusion: Our results suggest that the SML may affect the SFCT of the CSC, but not the PNV patients at least within four weeks following treatment. This effect seems to be independent of the change in choroidal perfusion measured with OCTA.

Author(s):  
Michelle Prasuhn ◽  
Yoko Miura ◽  
Aysegül Tura ◽  
Felix Rommel ◽  
Vinodh Kakkassery ◽  
...  

Background: Central serous chorioretinopathy (CSC) is a common macular condition characterized by detachment of the neuroretina and is a frequent cause of central vision loss in adults. Among the various therapeutic strategies, subthreshold microsecond pulsed laser (SML) treatment has become a useful option. Despite the suggested involvement of choroidal circulatory disturbances in CSC, effects of this treatment on macular microperfusion have not been fully evaluated yet. Herein, we report the impact of SML on retinal and choroidal microvascular flow using non-invasive optical coherence tomography (OCT) angiography (OCTA). Methods: In this study, CSC patients with persistent subretinal fluid (SRF) with or without secondary choroidal neovascularization (CNV) were included (referred to as pachychoroid neovasculopathy (PNV) group and CSC group, respectively). SML was conducted using a yellow (577 nm) laser with duty cycle of 10%, spot size of 200 µm and duration of 200 ms. Best corrected visual acuity (BCVA) as well as OCT and OCTA images were evaluated at baseline and 4 weeks after SML. OCTA parameters of interest included full retinal perfusion (FRP), choriocapillaris perfusion (CCP), Sattler’s layer perfusion (SLP), and Haller’s layer perfusion (HLP), which were evaluated longitudinally and compared to unaffected fellow eyes. Results: 27 affected eyes and 17 fellow eyes from 27 patients were included. Before treatment, central retinal thickness (CRT) and subfoveal choroidal thickness (SFCT) of affected eyes were significantly larger than in fellow eyes. Four weeks after SML, CRT decreased significantly, whereas perfusion parameters did not change. In subgroup analyses, the CSC group showed a significant decrease of SFCT, whereas the PNV group did not despite the decrease of CRT. Conclusion: Our results suggest that the SML may SFCT of CSC, but not of PNV patients at least within four weeks following treatment. This effect seems to be independent of the change in choroidal perfusion measured with OCTA.


F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1706 ◽  
Author(s):  
Jose R. Davila ◽  
Prithvi Mruthyunjaya

Innovations in ophthalmic imaging have made a profound impact on the diagnosis and treatment of ophthalmic disease. In ocular oncology, the development of optical coherence tomography with enhanced depth imaging and swept source technologies has made it possible to visualize the anatomical characteristics of retinoblastoma and uveal melanoma with a level of detail previously unobtainable on clinical exam alone. As a result, our understanding of the pathophysiology of vision loss in choroidal melanoma in particular has improved. These modalities have also helped identify fundoscopically “invisible” tumors and risk stratify pre-malignant choroidal lesions, making a strong case for their inclusion in all screening evaluations. Optical coherence tomography angiography, on the other hand, has allowed non-invasive imaging of the retinal and uveal vasculatures, providing insight into vascular changes associated with malignant transformation and vision loss following exposure to radiation. While the impact of new imaging technologies on clinical outcomes and overall survival in ocular oncology has yet to be determined, several reports cited herein offer promising results.


2021 ◽  
Vol 2 (1) ◽  
pp. 31-36
Author(s):  
Ragai Magdy Hatata ◽  
◽  
Sherin Hassan Sadek ◽  

AIM: To study the changes in choroidal thickness in central serous chorioretinopathy (CSCR) over a 3mo follow-up using spectral domain optical coherence tomography (SD-OCT). METHODS: This prospective study included 60 eyes, both eyes of 20 patients (mean age: 33.65±5.24y) with classic acute unilateral central serous chorioretinopathy and normal fellow eye and 20 eyes as healthy controls. Fluorescein angiography and OCT were done. The subfoveal choroidal thickness (SFCT), central macular thickness (CMT), 1000 μm temporal and nasal to the centre of the fovea and the subretinal fluid were measured. RESULTS: There was a statistically significant difference in SFCT among the three groups at the three different locations. SFCT in eyes with CSCR (372.40±34.39 μm) was significantly greater than that in each of the unaffected fellow eyes (302.10±8.9 μm) and control eyes (279.80±14.49 μm) at the base line and after 3mo follow-up. The mean CMT in CSCR was 317±141.86 μm, with a statistically significant positive correlation between SFCT and CMT. CONCLUSION: The increase in the choroidal thickness at different locations as well as hyper-dilated and hyper-permeable vessels known as “pachychoroid” seems to play an important role in a broad spectrum of diseases that includes central serous chorioretinopathy.


2019 ◽  
pp. bjophthalmol-2018-313576 ◽  
Author(s):  
Spoorti Krishna Reddy Mandadi ◽  
Sumit Randhir Singh ◽  
Niroj Kumar Sahoo ◽  
Sai Bhakti Mishra ◽  
Riccardo Sacconi ◽  
...  

AimTo evaluate the optical coherence tomography angiography (OCTA) features of fellow eyes of patients with unilateral choroidal neovascularisation (CNV) associated with chronic central serous chorioretinopathy (CSCR).MethodsMedical records of patients with chronic CSCR who had undergone OCT angiography of both the eyes were reviewed. Patients with evidence of unilateral CNV detected by conventional imaging (OCT, fluorescein angiography and/or indocyanine green angiography) were included in the study. The OCT and OCTA characteristics of fellow eyes were analysed.ResultsForty patients (80 eyes—40 fellow eyes) with chronic CSCR with evidence of CNV in one eye were included. Mean age of the patients was 54.9±9.9 years and 82.5 % were males. Twenty-five (62.5%) fellow eyes had flat irregular pigment epithelial detachment on OCT, out of which 21 had internal hyper-reflectivity. A definite vascular network was picked up by OCTA in 9 of these 40 fellow eyes (22.5%) which was not detected on conventional imaging. In addition, two eyes had an ill-defined hyper-reflectivity, which could not be classified as a definite network at that point of time. The networks detected on OCTA in fellow eyes were mostly inactive, suggesting a subclinical neovascularisation.ConclusionOne-fourth of fellow eyes showed vascular network which could not be diagnosed on conventional imaging which highlights the importance of imaging both the eyes of chronic CSCR for early detection of CNV using OCTA. Further longitudinal studies are needed to assess the clinical course of such subclinical vascular networks in CSCR.


Sensors ◽  
2019 ◽  
Vol 19 (21) ◽  
pp. 4732
Author(s):  
Macarena Díaz ◽  
Marta Díez-Sotelo ◽  
Francisco Gómez-Ulla ◽  
Jorge Novo ◽  
Manuel Francisco G. Penedo ◽  
...  

Optical Coherence Tomography Angiography (OCTA) constitutes a new non-invasive ophthalmic image modality that allows the precise visualization of the micro-retinal vascularity that is commonly used to analyze the foveal region. Given that there are many systemic and eye diseases that affect the eye fundus and its vascularity, the analysis of that region is crucial to diagnose and estimate the vision loss. The Visual Acuity (VA) is typically measured manually, implying an exhaustive and time-consuming procedure. In this work, we propose a method that exploits the information of the OCTA images to automatically estimate the VA with an accurate error of 0.1713.


2019 ◽  
Vol 6 (1) ◽  
Author(s):  
Kai Yuan Tey ◽  
Kelvin Teo ◽  
Anna C. S. Tan ◽  
Kavya Devarajan ◽  
Bingyao Tan ◽  
...  

Abstract Background Diabetic retinopathy (DR) is a leading cause of vision loss in adults. Currently, the standard imaging technique to monitor and prognosticate DR and diabetic maculopathy is dye-based angiography. With the introduction of optical coherence tomography angiography (OCTA), it may serve as a potential rapid, non-invasive imaging modality as an adjunct. Main text Recent studies on the role of OCTA in DR include the use of vascular parameters e.g., vessel density, intercapillary spacing, vessel diameter index, length of vessels based on skeletonised OCTA, the total length of vessels, vascular architecture and area of the foveal avascular zone. These quantitative measures may be able to detect changes with the severity and progress of DR for clinical research. OCTA may also serve as a non-invasive imaging method to detect diabetic macula ischemia, which may help predict visual prognosis. However, there are many limitations of OCTA in DR, such as difficulty in segmentation between superficial and deep capillary plexus; and its use in diabetic macula edema where the presence of cystic spaces may affect image results. Future applications of OCTA in the anterior segment include detection of anterior segment ischemia and iris neovascularisation associated with proliferative DR and risk of neovascular glaucoma. Conclusion OCTA may potentially serve as a useful non-invasive imaging tool in the diagnosis and monitoring of diabetic retinopathy and maculopathy in the future. Future studies may demonstrate how quantitative OCTA measures may have a role in detecting early retinal changes in patients with diabetes.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Dominika Podkowinski ◽  
Bernhard Foessl ◽  
Luis de Sisternes ◽  
Sophie Beka ◽  
Anna-Sophie Mursch-Edlmayr ◽  
...  

AbstractThe purpose of the study was to evaluate the retinal blood flow in patients with acute central serous chorioretinopathy (CSC) over an observational period of 1 month using swept-source optical coherence tomography (SS-OCTA), focusing especially on changes in the area of subretinal fluid (A-SRF). We correlated these findings with conventional indocyanine green angiography (ICGA). ICGA and SS-OCTA images were collected and analyzed of 12 eyes of 12 patients. The A-SRF was annotated and a qualitative analysis of choriocapillaris, the vessel density (VD) and perfusion density (PD) of the retinal superficial capillary plexus (SCP) and the deep capillary plexus (DCP) was performed in A-SRF and the unaffected remaining area (RA). The VD and PD in the DCP were statistically significantly lower in A-SRF than in the RA at baseline. (VD: p = 0.014; PD: p = 0.036). After 1 month, there was a statistically significant difference in the VD and PD of the DCP (VD: p = 0.015; PD: p = 0.014), and for the PD of the SCP between the A-SRF and the RA (p = 0.015), with lower values in the A-SRF. We found low perfused areas in choriocapillaris corresponding to hypofluorescent areas on ICGA. In conclusion there is a difference in VD and VD of the DCP in the area of SRF in acute CSC. These alterations may lead to a chronic change in the microvasculature and potentially to morphological changes.


Sign in / Sign up

Export Citation Format

Share Document