Abstract
Purpose: to compare informativity and accordance of indocyanine green angiography (ICGA) and optical coherence tomography angiography (OCT-A) data in visualization of neovascularization associated with chronic central serous chorioretinopathy. Patients andMethods. Twenty one eye of 21 patients (aged 51.0 ± 8.4 years old) with chronic central serous chorioretinopathy (CSR) and assumed choroidal neovascularisation (CNV) with «double layer» sign on optical coherence tomography scans were enrolled in this study. ICGA on Spectralis HRA+OCT, (Heidelberg Engeneering, Germany) and OCT-A on RTVue XR Avanti (Optovue, USA) were performed to evaluate CNV. The assessment of obtained pictures was examined by two experts.Results. Both diagnostic methods have shown similar results. CNV has been revealed in 11 of 21 eyes by ICGA imaging while OCT-A confirmed neovascularization in 13 eyes — with no statistical difference between methods (p = 0.74, χ2). CNV has not been diagnosed in 10 cases by ICGA and in 8 cases by OCT-A (p = 0.69). However, the consistency of the two methods in CNV evaluation while pairwise comparison of angiography data has been confirmed only in 8 eyes. The absence of CNV has been confirmed in 6 eyes — mostly in patients with CSR recurrence. One third of patients (7 of 21 eyes) have not shown consistence of two methods. The OCT-A visualization of CNV could be poor because of subretinal deposits and pigment-related signal blocking. In cases of diffuse retinal pigment epithelium atrophy the neovascular network cannot been seen on ICGA images while well visualized on OCT-A.Conclusion. The informativity of ICGA and OCT-A in visualization of neovascularization associated with chronic central serous chorioretinopathy is similar. For the best data interpretation the condition of neurosensory retina and pigment retinal epitheluium should be taken into account. OCT-A is more preferable in cases of diffuse epitheliopathy, while the neovascularization activity and leakage points is better seen on ICGA.
Highlights
Центральная серозная хориоретинопатия (ЦСХ) имеет сложную природу и не до конца изученный патогенез, в основе которого лежит патология хориокапилляров и пигментного эпителия
data in visualization of neovascularization associated with chronic central serous chorioretinopathy
double layer» sign on optical coherence tomography scans were enrolled in this study
Summary
В исследование включен 21 пациент (21 глаз) с диагнозом «хроническая центральная серозная хориоретинопатия» и предполагаемой субретинальной неоваскуляризацией, находящиеся под наблюдением в отделе лазерной хирургии сетчатки ФГАУ «МНТК “Микрохирургия глаза”» в период с октября 2016-го по сентябрь 2017 года. Для определения критериев включения пациентам проводили спектральную ОКТ с использованием модуля улучшенной глубины изображения (EDI-OКT) к оптическому когерентному томографу с помощью прибора Spectralis HRA+OCT (Heidelberg Engineering, Германия) по протоколу Posterior Pole, состоящему из 61 скана и площадью сканирования макулярной зоны 30 × 25° с последующим анализом всех сканов. Для выявления СНМ основными диагностическими методами были ангиография с одномоментным введением красителей индоцианина зеленого и флюоресцеина (Spectralis HRA+OCT, Heidelberg Engeneering, Германия) и ОКТ-ангиография (RTVue XR Avanti, Optovue, США). Наличие скрытой неоваскуляризации определялось при контурировании аномальной сети тонких сосудов в ранней фазе с последующим накоплением красителя к средней и поздней фазе ангиографии. Для расчета согласованности двух методов исследования в плане выявления СНМ 1-го типа (номинальный признак) использовали критерий хи-квадрат.
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