OCT Angiography of the Choriocapillaris in Central Serous Chorioretinopathy: A Quantitative Subgroup Analysis
Tóm tắt
To quantify optical coherence tomography angiography (OCTA) signal changes at the level of the choriocapillaris (CC) in patients with different stages of central serous chorioretinopathy (CSC) and to explore any correlation between subretinal fluid (SRF) and retinal pigment epithelium (RPE) alterations and the OCTA CC signal. One hundred one CSC eyes and 42 healthy control eyes were included in this retrospective study. CSC patients were allocated into four groups: acute, non-resolving, chronic atrophic and inactive CSC. CC OCTA images (AngioPlex®, Zeiss) were automatically quantified using an image-processing algorithm. Spatial correlation analysis of OCTA signals was performed by overlapping macular edema heatmaps and fundus autofluorescence images with corresponding OCTA images. Active CSC subgroups demonstrated significantly more increased and decreased flow pixels in the CC compared with controls (p < 0.0001). No significant OCTA changes were seen within the active CSC groups or between the inactive and healthy subgroup. Spatial correlation analysis revealed a decreased OCTA signal in the SRF area and an increased signal outside the SRF area in acute CSC. Areas of RPE atrophy co-localized with areas of increased choriocapillaris OCTA signal, while areas with RPE alterations exhibited a normal signal compared with unaffected RPE. The decreased OCTA signal in the area of SRF in acute CSC could be evidence of localized CC hypoperfusion or due to shadowing artifacts. The missing CC OCTA changes in altered RPE adjacent to atrophy argues against CC injury. Studies with higher resolution and optimized image acquisition are warranted to further validate our findings.
Tài liệu tham khảo
Wang M, Munch IC, Hasler PW, Prünte C, Larsen M. Central serous chorioretinopathy. Acta Ophthalmol (Copenh). 2008;86:126–45.
Kitzmann AS, Pulido JS, Diehl NN, Hodge DO, Burke JP. The incidence of central serous chorioretinopathy in Olmsted county, Minnesota, 1980–2002. Ophthalmology. 2008;115:169–73.
Daruich A, Matet A, Behar-Cohen F. Central serous chorioretinopathy. Dev Ophthalmol. 2017;58:27–38.
Daruich A, Matet A, Dirani A, Bousquet E, Zhao M, Farman N, et al. Central serous chorioretinopathy: recent findings and new physiopathology hypothesis. Prog Retin Eye Res. 2015;48:82–118.
Bousquet E, Beydoun T, Zhao M, Hassan L, Offret O, Behar-Cohen F. Mineralocorticoid receptor antagonism in the treatment of chronic central serous chorioretinopathy: a pilot study. Retina Phila Pa. 2013;33:2096–102.
Zhao M, Célérier I, Bousquet E, Jeanny J-C, Jonet L, Savoldelli M, et al. Mineralocorticoid receptor is involved in rat and human ocular chorioretinopathy. J Clin Invest. 2012;122:2672–9.
Alten F, Heiduschka P, Clemens CR, Eter N. Exploring choriocapillaris under reticular pseudodrusen using OCT-angiography. Graefes Arch Clin Exp Ophthalmol Albrecht Von Graefes Arch Klin Exp Ophthalmol. 2016;254:2165–73.
Teussink MM, Breukink MB, van Grinsven MJJP, Hoyng CB, Klevering BJ, Boon CJF, et al. OCT angiography compared to fluorescein and indocyanine green angiography in chronic central serous chorioretinopathy. Invest Ophthalmol Vis Sci. 2015;56:5229–37.
Quaranta-El Maftouhi M, El Maftouhi A, Eandi CM. Chronic central serous chorioretinopathy imaged by optical coherence tomographic angiography. Am J Ophthalmol. 2015;160(581–587):e1.
Dansingani KK, Balaratnasingam C, Klufas MA, Sarraf D, Freund KB. Optical coherence tomography angiography of shallow irregular pigment epithelial detachments in pachychoroid spectrum disease. Am J Ophthalmol. 2015;160(1243–1254):e2.
Bonini Filho MA, de Carlo TE, Ferrara D, Adhi M, Baumal CR, Witkin AJ, et al. Association of choroidal neovascularization and central serous chorioretinopathy with optical coherence tomography angiography. JAMA Ophthalmol. 2015;133:899–906.
Costanzo E, Cohen SY, Miere A, Querques G, Capuano V, Semoun O, et al. Optical coherence tomography angiography in central serous chorioretinopathy. J Ophthalmol. 2015;2015:134783.
de Carlo TE, Rosenblatt A, Goldstein M, Baumal CR, Loewenstein A, Duker JS. Vascularization of irregular retinal pigment epithelial detachments in chronic central serous chorioretinopathy evaluated with OCT angiography. Ophthalmic Surg Lasers Imaging Retina. 2016;47:128–33.
Shinojima A, Kawamura A, Mori R, Fujita K, Yuzawa M. Findings of optical coherence tomographic angiography at the choriocapillaris level in central serous chorioretinopathy. Ophthalmol J Int Ophtalmol Int J Ophthalmol Z Für Augenheilkd. 2016;236:108–13.
Feucht N, Maier M, Lohmann CP, Reznicek L. OCT angiography findings in acute central serous chorioretinopathy. Ophthalmic Surg Lasers Imaging Retina. 2016;47:322–7.
Chan SY, Wang Q, Wei WB, Jonas JB. Optical coherence tomographic angiography in central serous chorioretinopathy. Retina Phila Pa. 2016;36:2051–8.
Cakir B, Reich M, Lang SJ, Bühler A, Stahl A, Böhringer D, et al. Possibilities and limitations of OCT-angiography in patients with central serous chorioretinopathy. Klin Monatsbl Augenheilkd. 2017;234:1161–8.
Choi W, Mohler KJ, Potsaid B, Lu CD, Liu JJ, Jayaraman V, et al. Choriocapillaris and choroidal microvasculature imaging with ultrahigh speed OCT angiography. PLoS One. 2013;8:e81499.
Braaf B, Vienola KV, Sheehy CK, Yang Q, Vermeer KA, Tiruveedhula P, et al. Real-time eye motion correction in phase-resolved OCT angiography with tracking SLO. Biomed Opt Express. 2013;4:51–65.
Bousquet E, Bonnin S, Mrejen S, Krivosic V, Tadayoni R, Gaudric A. Optical coherence tomography angiography of flat irregular pigment epithelium detachment in chronic central serous chorioretinopathy. Retina. 2018;38(3):629–638
Tittl M, Maar N, Polska E, Weigert G, Stur M, Schmetterer L. Choroidal hemodynamic changes during isometric exercise in patients with inactive central serous chorioretinopathy. Invest Ophthalmol Vis Sci. 2005;46:4717–21.
Kitaya N, Nagaoka T, Hikichi T, Sugawara R, Fukui K, Ishiko S, et al. Features of abnormal choroidal circulation in central serous chorioretinopathy. Br J Ophthalmol. 2003;87:709–12.
Scheider A, Nasemann JE, Lund OE. Fluorescein and indocyanine green angiographies of central serous choroidopathy by scanning laser ophthalmoscopy. Am J Ophthalmol. 1993;115:50–6.
Spaide RF, Fujimoto JG, Waheed NK. Image artifacts in optical coherence tomography angiography. Retina Phila Pa. 2015;35:2163–80.
McLeod DS, Grebe R, Bhutto I, Merges C, Baba T, Lutty GA. Relationship between RPE and choriocapillaris in age-related macular degeneration. Invest Ophthalmol Vis Sci. 2009;50:4982–91.
Saint-Geniez M, Kurihara T, Sekiyama E, Maldonado AE, D’Amore PA. An essential role for RPE-derived soluble VEGF in the maintenance of the choriocapillaris. Proc Natl Acad Sci USA. 2009;106:18751–6.
Schlingemann RO. Role of growth factors and the wound healing response in age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol Albrecht Von Graefes Arch Klin Exp Ophthalmol. 2004;242:91–101.
Kvanta A, Casselholm de Salles M, Amrén U, Bartuma H. Optical coherence tomography angiography of the foveal microvasculature in geographic atrophy. Retina Phila Pa. 2017;37:936–42.
Pellegrini M, Acquistapace A, Oldani M, Cereda MG, Giani A, Cozzi M, et al. Dark atrophy: an optical coherence tomography angiography study. Ophthalmology. 2016;123:1879–86.
Sparrow JR, Kim SR, Cuervo AM, Bandhyopadhyayand U. A2E, a pigment of RPE lipofuscin, is generated from the precursor, A2PE by a lysosomal enzyme activity. Adv Exp Med Biol. 2008;613:393–8.
McLeod DS, Taomoto M, Otsuji T, Green WR, Sunness JS, Lutty GA. Quantifying changes in RPE and choroidal vasculature in eyes with age-related macular degeneration. Invest Ophthalmol Vis Sci. 2002;43:1986–93.