Session Title: Imaging IV
Session Date/Time: Sunday 20/09/2015 | 11:00-13:00
Paper Time: 11:32
First Author: : T.Theelen NETHERLANDS
Co Author(s): : M. Teussink M. Breukink M. van Grinsven C. Hoyng
PURPOSE:The pathophysiology of the subretinal fluid accumulation in chronic central serous chorioretinopathy (cCSC) is poorly understood. We used a multimodal approach of fluorescein angiography (FA), indocyanin green angiography (ICGA) and optical coherence tomography (OCT) based split-spectrum amplitude-decorrelation angiography (SSADA) to examine the blood flow in retina and choroid of patients with cCSC. SSADA registers cellular movement rather than plasma movement. Therefore, information received by FA, ICGA and SSADA imaging is expected to be supplementary to each other in cCSC.
This was a single center, retrospective, observational case series on patients with cCSC.
We examined regularly scheduled, consecutive patients with cCSC seen at the outpatient clinic of the Department of Ophthalmology, Radboudumc, Nijmegen, the Netherlands. All patients underwent FA, ICGA and spectral domain OCT exams. In addition, SSADA was performed by a novel OCT angiography device (AngioVue™, Optovue Inc.), which allows three dimensional analysis of vessels at the ocular fundus. SSADA images were aligned to FA and ICGA, and image series were exported to an image grading software. Images were then graded manually by two masked human observers in a randomized fashion. Observers delineated areas on SSADA images of cCSC patients that showed considerably higher or lower pixel intensities as compared to a series of SSADA scans of healthy subjects. In addition, areas of abnormal fluorescence in FA and ICGA were outlined and compared to the annotated abnormal areas in SSADA images.
We analysed 24 eyes of 17 patients with cCSC. Twelve patients were treatment naive, and 5 patients received either half-dose photodynamic therapy, or micropulse laser treatment, or both, before inclusion into our study. In all patients with active cCSC abnormal areas were seen on SSADA and ICGA. There were no systematically recorded signal irregularities in retinal SSADA scans, however, on choroidal SSADA scans, abnormalities were regularly seen. In general, regions with an abnormal signal on SSADA were co-localized with areas of ICGA irregularity. Correlation with FA was less obvious.
In our series of cCSC patients, abnormalities in choroidal SSADA scans were co-localized with obviously pathologic areas on ICGA of the same patients. While ICGA and FA provides information on fluid leakage and tissue staining, SSADA may help to understand the corresponding disorder of choroidal blood perfusion in cCSC.