Optical Coherence Tomography Angiography Compared with Indocyanine Green Angiography in Central Serous Chorioretinopathy

Guosheng Sun,Jinfeng Qu,Jie Hu,Yuou Yao,Mengyang Li,Zhenyu Piao,Mingwei Zhao

doi:10.1038/s41598-019-42623-x

Abstract

The purpose of this article is to compare optical coherence tomography angiography (OCTA) and indocyanine green angiography (ICGA) in patients with central serous chorioretinopathy (CSC). OCTA, ICGA and fluorescein angiography (FA) images of all enrolled patients were collected and compared. Abnormal areas were annotated on en face choriocapillaris OCTA and ICGA images and compared with each other. We found three main types of anomalies in choriocapillaris OCTA images: type A, coarse granulated high reflective area (61 eyes [92.4%]); type B, roundish dark halo around Type A (54 eyes [81.8%]); and type C, coarse granulated low reflective area (66 eyes [100%]). There were 54 eyes (81.8%) that exhibited all three types abnormalities, 7 (10.6%) had only type A and C abnormalities, and 5 (7.6%) had only type C abnormalities. The Mean JI of type A on OCTA and hyperfluorescence area on ICGA was 0.84 ± 0.15 and 0.82 ± 0.23 for grader 1 and 2, respectively. Type A area on OCTA had a statistically larger area than hyperfluorescence on ICGA (P = 0.01 [paired t-test]). In summary, abnormalities were found on OCTA images of CSC. Coarse granulated high reflective area in OCTA corresponded well with the hyper-permeability area in ICGA in most of the eyes.

Highlights

The imaging techniques mentioned above can help to diagnose most cases of central serous chorioretinopathy (CSC) and differentiate from other diseases, fluorescein angiography (FA) and indocyanine green angiography (ICGA) are invasive techniques that require a high demand for trained technicians and patient cooperation
Patients with other ocular conditions commonly associated with SRF, such as choroidal neovascularization, polypoidal choroidal vasculopathy (PCV), diabetic retinopathy, retinal vascular occlusion, Coat’s disease, or any disease that may affect the quality of imaging, such as cataract, high myopia or nystagmus; history of ocular surgeries including retinal laser; pregnancy; any uncontrolled systemic disease; or any condition rendering patients intolerable to image acquisition were excluded
We found 54 eyes (75%) presenting double-layer sign (DLS) in OCT B-scans. 6 of them were found abnormal vascular network, which could be choroidal neovascularization (CNV) or branching vascular network (BVN), within the DLS on OCT angiography (OCTA) images after manually adjusting the slab boundary just above and under the DLS

Summary

Introduction

The imaging techniques mentioned above can help to diagnose most cases of CSC and differentiate from other diseases, FA and ICGA are invasive techniques that require a high demand for trained technicians and patient cooperation. Because abnormal choroidal blood flow is considered to be important in the pathogenesis of CSC, OCTA may provide additional information about blood supply in CSC, and may help to better understand the underlying pathophysiology of the disease. Previous studies[7,13,14,15,16] have described findings of OCTA with CSC. The aim of the present study was to describe OCTA findings in Asian patients with chronic and acute CSC, and to compare OCTA with traditional angiographic imaging modalities

Objectives

Methods

Results

Conclusion