Abstract
PurposeTo report the observation of the choriocapillaris island (CCI) on optical coherence tomography angiography (OCTA) in eyes with active central serous chorioretinopathy (CSCR), and to investigate its associated clinical features.DesignRetrospective observational study.MethodsPatients diagnosed with active CSCR underwent OCTA imaging (Optovue Inc, Fremont, California, USA), and the software built-in en face choriocapillaris slab was examined to demonstrate CCI, defined as an area of detectable choriocapillaris flow surrounded by an area of undetectable or diminished flow. Electronic medical records (EMR) were reviewed for demographics, clinical data, other imaging modalities and any intervention, and these parameters were correlated with CCI findings.Results25 eyes of 25 patients were recruited. CCI was detected in all examined eyes and was best elucidated on the en face choriocapillaris density maps. 24 eyes had focal retinal pigment epithelium (RPE) alterations overlying CCI. All 14 eyes with simultaneous fundus fluorescein angiography (FA) showed actively leaking point(s) well corresponding to the CCI location. Resolution of sub-retinal fluid in 4 eyes was associated with disappearance of CCI on follow-up OCTA scans. 1 eye showed complicating neovascularization 5 months after the initial presentation at the same location of the CCI.ConclusionWe demonstrate the observation of the “choriocapillaris island” an OCTA finding in eyes with active CSCR underneath the area of neurosensory detachment. CCI may constitute an angiographic representation of the focal area of choriocapillaris structural and functional affection, with secondary RPE alteration jeopardizing its barrier function. Larger longitudinal studies are needed to further elucidate this finding.
Highlights
Central serous chorioretinopathy (CSCR) is an idiopathic chorioretinal disorder typically affecting young and middle-aged adults with a higher male predilection, and represents the fourth most common non-surgical retinal disease in terms of incidence [1, 2]
We demonstrate the observation of the “choriocapillaris island” an optical coherence tomography angiography (OCTA) finding in eyes with active CSCR underneath the area of neurosensory detachment
choriocapillaris island (CCI) may constitute an angiographic representation of the focal area of choriocapillaris structural and functional affection, with secondary retinal pigment epithelium (RPE) alteration jeopardizing its barrier function
Summary
Central serous chorioretinopathy (CSCR) is an idiopathic chorioretinal disorder typically affecting young and middle-aged adults with a higher male predilection, and represents the fourth most common non-surgical retinal disease in terms of incidence [1, 2]. Optical coherence tomography angiography (OCTA) has been introduced as a non-invasive imaging modality enabling in-vivo angiographic visualization of different retinal and choroidal disorders [20] This technology allows a more in-depth representation of the chorioretinal vasculature, including the choriocapillaris which plays a crucial role in CSCR pathogenesis
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