First Author: K.Manethova CZECH REPUBLIC
Co Author(s): J. Ernest
Back to previous
We analyze new optical coherence tomography angiography (OCT-A) findings in patients with chronic form of central serous chorioretinopathy (CSC) after half-dose photodynamic therapy (rPDT) and we confront them with those obtained with other imaging modalities.
A group of subsequent patients diagnosed with chronic CSC at the Eye clinic of Military University Hospital Prague was examined with OCT-A, fluorescein angiography, indocyanin green angiography and optical coherence tomography. All patients underwent half-fluence PDT at least 1 months preceding OCT-A examination. OCT-A was investigated on the two main levels - automatically segmented outer retina and automatically segmented choriocapillaris. Anti-VEGF was injected in case of active choroidal neovascularization (CNV) presence.
33 eyes of 31 patients with chronic CSC after rPDT were examined and analyzed with OCT-A. OCT-A in this series of eyes revealed following features: dark zones in 29/33 eyes (89%), which were sometimes associated with serous retinal detachment or with choriocapillary blood flow reduction; dark spots were detected at 13/33 eyes (39%), mostly linked to serous retinal pigment epithelium detachment; and occurrence of choroidal vessels abnormalities (24/33, 72%), especially dilated vessels that were accompanied by presence of CNV in 14/33 eyes (42%), which is more than it has been reported in literature so far (24%).
OCT-A in eyes with chronic CSC after rPDT showed dark areas, dark spots and choroidal abnormalities. CNV is a late complication of chronic CSC. OCT-A seems to be a new imaging tool allowing more detailed diagnostics of CSC complications in much higher rate than it has been reported so far. Reduced fluence PDT is considered to be a dominant therapeutical approach in recent years, however, in presence of CNV as a complication of CSC (diagnosed with OCT-A) we should think of combination therapy with rPDT + anti-VEGF. We will present our results of chronic CSC therapy with rPDT. According to a detection of active CNV on OCT-A post rPDT, combination therapy with anti-VEGF was performed.