Coherence Tomography Scans Of Eyes Research Articles

Outer retinal tubulations in central serous chorioretinopathy associated with choroidal neovascularisation.

To report the prevalence and characteristics of outer retinal tubulations in eyes with choroidal neovascularisation associated with chronic central serous chorioretinopathy. Retrospective case series which included evaluation of optical coherence tomography B-scans and enface optical coherence tomography scans of eyes with choroidal neovascularisation associated with chronic central serous chorioretinopathy. The characteristics of outer retinal tubulations such as number, shape and distribution were noted. The location of the outer retinal tubulations was correlated with autofluorescence. Outer retinal tubulations were detected in 9.1% of the eyes (9 out of 87 eyes). The average number of outer retinal tubulations in each eye was 4.7 ± 4.6. Spheroidal outer retinal tubulations were more common than the branching tubules. Although presence of outer retinal tubulations was mostly associated with inactive disease, two eyes had coexistent subretinal fluid. Outer retinal tubulations associated with choroidal neovascularisation in chronic central serous chorioretinopathy, though less frequent, when present are more numerous, mostly extrafoveal and more spheroidal in shape compared to outer retinal tubulations associated with age-related macular degeneration and other degenerative conditions.

Retinal and choroidal changes in steroid-associated central serous chorioretinopathy

BackgroundTo evaluate the retinal and choroidal alterations in steroid-associated central serous chorioretinopathy (CSC) in comparison to idiopathic CSC.MethodsIn this retrospective cohort study, swept source optical coherence tomography scans of eyes with steroid-associated CSC (group A) were compared with the same in idiopathic CSC (group B). The key features included central subfield retinal thickness, subfoveal choroidal thickness, subfoveal large choroidal vessel diameter, subretinal deposits, retinal pigment epithelial irregularities, double layer sign, hyperreflective dots, intraretinal fluid, and choroidal vascularity index (ratio of choroidal luminal area and total choroidal area, measured on a high definition horizontal 9 mm OCT B-scan.ResultsThere were 20 eyes in group A and 30 in group B. Group A had a higher female proportion (60 vs. 16.67%; P < 0.01) and higher bilaterality (30 vs. 6.67%; P = 0.03). The height of neurosensory detachment was lower in group A (153.1 ± 175.70 µm vs. 312.9 ± 223.06 µm; P < 0.01). There was no significant difference in the prevalence of subretinal deposits, retinal pigment epithelial irregularities, pigment epithelial detachments, double layer sign, outer retinal layer disruption, and intraretinal fluid. Hyperreflective dots (HRDs) were less common in group A (15 vs. 46.67%; P = 0.03). The subfoveal choroidal thickness (P = 0.65) and subfoveal large choroidal vessel diameter (P = 0.78) were comparable. There was a trend towards a higher choroidal vascularity index (CVI) in group A (A: mean, 82%, 95% CI, 66–99%; B: mean, 58%, 95% CI, 57–59%; P = 0.10).ConclusionSteroid-associated CSC has a marginally higher CVI and less common association with HRDs as compared to idiopathic CSC.

Analyzing and Predicting Visual Acuity Outcomes of Anti-VEGF Therapy by a Longitudinal Mixed Effects Model of Imaging and Clinical Data.

We develop a longitudinal statistical model describing best-corrected visual acuity (BCVA) changes in anti-VEGF therapy in relation to imaging data, and predict the future BCVA outcome for individual patients by combining population-wide trends and initial subject-specific time points. Automatic segmentation algorithms were used to measure intraretinal (IRF) and subretinal (SRF) fluid volume on monthly spectral-domain optical coherence tomography scans of eyes with central retinal vein occlusion (CRVO) receiving standardized anti-VEGF treatment. The trajectory of BCVA over time was modeled as a multivariable repeated-measure mixed-effects regression model including fluid volumes as covariates. Subject-specific BCVA trajectories and final treatment outcomes were predicted using a population-wide model and individual observations from early follow-up. A total of 193 eyes (one per patient, 12-month follow-up, 2420 visits) were analyzed. The population-wide mixed model revealed that the impact of fluid on BCVA is highest for IRF in the central millimeter around the fovea, with -31.17 letters/mm3 (95% confidence interval [CI], -39.70 to -23.32), followed by SRF in the central millimeter, with -17.50 letters/mm3 (-31.17 to -4.60) and by IRF in the parafovea, with -2.87 letters/mm3 (-4.71 to -0.44). The influence of SRF in the parafoveal area was -1.24 letters/mm3 (-3.37-1.05). The conditional R2 of the model, including subject-specific deviations, was 0.887. The marginal R2 considering the population-wide trend and fluid changes was 0.109. BCVA at 1 year could be predicted for an individual patient after three visits with a mean absolute error of six letters and a predicted R2 of 0.658 using imaging information. The mixed-effects model revealed that retinal fluid volumes and population-wide trend only explains a small proportion of the variation in BCVA. Individual BCVA outcomes after 1 year could be predicted from initial BCVA and fluid measurements combined with the population-wide model. Accounting for fluid in the predictive model increased prediction accuracy.

CHOROIDAL VASCULARITY INDEX IN CENTRAL SEROUS CHORIORETINOPATHY.

To evaluate choroidal vascularity index (CVI) in eyes with central serous chorioretinopathy (CSC) using an image binarization tool on enhanced depth imaging using spectral domain optical coherence tomography scans. In this retrospective cohort study, enhanced depth imaging optical coherence tomography scans of both eyes of patients with CSC were taken at baseline; they were segmented and compared with enhanced depth imaging optical coherence tomography scans of fellow eyes without CSC as well as age-matched healthy subjects. Subfoveal choroidal area (1,500 μm) was segmented into luminal area and stromal area using image binarization. Choroidal vascularity index was defined as the proportion of luminal area to the total circumscribed subfoveal choroidal area. Eyes with acute CSC (32 eyes) had significantly higher CVI compared with their fellow eyes (27 eyes) (P < 0.0001), 19 eyes with resolved CSC (P < 0.0001) and with 30 eyes of age-matched healthy eyes (P < 0.0001). Fellow eyes of subjects with acute CSC also had significantly higher CVI compared with eyes with resolved CSC (P < 0.0001) and age-matched healthy eyes (P < 0.0001). Increased CVI suggests increased vascular component compared with the stromal component in acute CSC. Increased CVI was noted in fellow eye of the subjects with acute CSC in comparison with age-matched healthy subjects. The CVI could be a useful index for early diagnosis of CSC and to assess the treatment response after laser photocoagulation or photodynamic therapy.