First Author: E.Peiretti ITALY
Co Author(s): E. Peiretti G. Caminiti R. Serra C. Iovino
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Chronic central serous chorioretinopathy (CSCR) may predispose to the development of choroidal neovascularization (CNV) and polypoidal choroidal vasculopathy (PCV). The aim of the study is to evaluate OCT-A and indocyanine green angiography (ICGA) features in patients with Chronic CSCR complicated by PCV, before and after treatments.
Prospective study of consecutive series of patient affected chronic CSCR complicated by PCV
Eight eyes of seven consecutive patients with a diagnosis of PCV in chronic CSCR were analyzed on the basis of multimodal imaging. PCV patients were classified in 2 groups: the first group included 4 eyes treated with photodynamic therapy (PDT), the second group included 4 eyes treated with intravitreal injection (IVT) of anti-VEGF (bevacizumab, ranibizumab, aflibercept). OCT-A and ICGA were performed before and after treatment, in order to understand the effect of such therapies on the vascular networks. The fixed follow-up schedule was after 3 months for the PDT group and after 1 month for the IVT group.
At the baseline, in the whole series of patients, ICGA was able to detect 100% of the PCV and the data were confirmed by SD OCT analysis; OCT-A manual segmentation of different layers showed the polyp lesions either as an hyperreflective aneurysmatic dilatation surrounded by a dark halo or as an hypo-reflective round area. After therapy, in the first group (PDT treatment), the polyp lesions were not detectable either by ICGA as well as on OCT-A analysis in most of cases. In the second group (IVT of anti-VEGF), 75% of the eyes revealed the presence of PCV after treatment on ICGA while on OCT-A was difficult to confirm the presence of the aneurysmatic dilatations suggestive of PCV.
OCT-A can be considered a valuable tool in order to detect the PCV in CSCR but is debatable its use in the follow up of photodynamic therapy and IVT of anti-VEGF.