Optical Coherence Tomography Angiography in Central Serous Chorioretinopathy.

Eliana Costanzo,Ala’a El Ameen,Salomon Yves Cohen,Oudy Semoun,Hassiba Oubraham,Eric H. Souied,Alexandra Miere,Vittorio Capuano,Giuseppe Querques

doi:10.1155/2015/134783

Abstract

Purpose. To analyze optical coherence tomography angiography (OCTA) findings in eyes with central serous chorioretinopathy (CSC) and to compare them with those obtained with multimodal imaging. Methods. A series of consecutive patients diagnosed with CSC, underwent OCTA and multimodal imaging, including spectral domain OCT, fluorescein, and indocyanine green angiography. OCTA images were performed at three main depth intervals: automatically segmented outer retina, manually adjusted outer retina, and automatically segmented choriocapillaris. Results. Thirty-three eyes of 32 consecutive patients were analyzed. OCTA showed 3 main anomalies at the choriocapillaris: the presence of dark areas (19/33 eyes) which were frequently associated with serous retinal detachment, presence of dark spots (7/33 eyes) which were frequently associated with retinal pigment epithelium detachment, and presence of abnormal vessels (12/33 eyes) which were frequently, but not systematically, associated with choroidal neovascularization, as confirmed by multimodal imaging. Conclusions. OCTA revealed dark areas and dark spots, which were commonly observed. An abnormal choroidal pattern was also observed in one-third of cases, even when multimodal imaging did not evidence any choroidal neovascularization. Abnormal choroidal vessels should be interpreted with caution, and we could assume that this pathological choroidal vascular pattern observed in many CSC cases could be distinct from CNV.

Highlights

Central serous chorioretinopathy (CSC) is a disorder characterized by episodes of macular serous retinal detachment (SRD), first described and characterized as a clinical entity with fluorescein angiography (FA) [1,2,3]
CSC is characterized by retinal pigment epithelium (RPE) changes that are observed on fundus autofluorescence (FAF) pictures, serous retinal pigment epithelium detachment (PED), and episodes of SRD [12]
Eyes with abnormal choroidal vessel patterns were described with more details, with an attempt of classification according to the pattern

Summary

Introduction

Central serous chorioretinopathy (CSC) is a disorder characterized by episodes of macular serous retinal detachment (SRD), first described and characterized as a clinical entity with fluorescein angiography (FA) [1,2,3]. The disease may present with different patterns: acute CSC, “persisting,” recurrent, and chronic CSC [12]. It usually occurs in young males but may be observed in older subjects of both genders. FA usually shows areas of fluorescein leakage, often focal, with a smokestack or inkblot pattern in acute CSC [1,2,3], and more widespread in chronic stages, called diffuse retinal pigment epitheliopathy [1, 3]. CSC may be associated with polypoidal choroidal vasculopathy (PCV), and both entities may be overlapped [12, 17]

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