Swept-Source Optical Coherence Tomography Angiography in Central Serous Chorioretinopathy

Abstract

Purpose: This article aims to evaluate the appearance of central serous chorioretinopathy (CSC) with swept-source optical coherence tomography angiography (SS-OCTA), to discuss whether localization of the leakage spot seen on fluorescein angiography (FA) corresponds to any recognizable spot on SS-OCTA, and to provide subsequent diagnosis of choroidal neovascularization (CNV) in the course of CSC. Methods: A prospective interventional case series was conducted in a private outpatient office on 30 eyes of 27 patients. In addition to ophthalmic examination, FA, spectral-domain OCT, SS-OCT and SS-OCTA were performed at least once. If laser photocoagulation or anti-vascular endothelial growth factor (anti-VEGF) injection was administered, then all examinations were repeated afterward. Following SS-OCTA, morphology features of CSC were analyzed: localization of the leakage spot, presence of feeder vessels, and presence of CNV. Changes after treatment were recorded. Results: In 26 of 30 cases the leakage site on FA corresponded to a highly hyporeflective site on SS-OCTA. In 7 of these cases laser was successfully administered. In 20/30 eyes we additionally observed thickened vessels at the level of choriocapillaris in close proximity to the most hyporeflective spot. CNV was observed in 4 cases. The leakage spot is the most hyporeflective spot on SS-OCTA localized at the level of choriocapillaris. Additionally, choroidal feeder vessels might be visualized at the level of choriocapillaris in 66% of cases. In 4 eyes, CNV in the course of CSC was noted. Conclusions: In CSC, SS-OCTA is a valuable diagnostic tool and its results complement FA. It might add to the treatment process, especially regarding the need to start and to monitor anti-VEGF injections. Anti-VEGF treatment results in fading but not in complete disappearance of CNV in the course of CSC.