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Fasler K, Turgut F, Gunzinger JM, Sommer C, Muth DR, Kinzl S, Nilius H, Zweifel S, Somfai GM. Efficacy of Subthreshold Micropulse Laser for Central Serous Chorioretinopathy. Klin Monbl Augenheilkd 2024; 241:489-495. [PMID: 38653299 DOI: 10.1055/a-2229-2298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
PURPOSE To evaluate the efficacy of a subthreshold micropulse laser (SML) in patients with central serous chorioretinopathy (CSCR). METHODS Retrospective clinical study conducted at the Departments of Ophthalmology at a university and a municipal hospital in Zurich, Switzerland. We enrolled acute and chronic CSCR patients with persistent subretinal fluid (SRF) treated with SML. Two treatment protocols (fluorescein/indocyanine green angiography or optical coherence tomography guided) were evaluated for efficacy after 3 and 6 months. The primary outcomes of the study were reduction and percentage of eyes with complete resolution of SRF 3 and 6 months after SML treatment. Secondary endpoints included changes in central subfield thickness (CST) and visual acuity (VA) after 3 and 6 months. RESULTS The study involved 37 eyes (35 patients, 48.6% chronic). A statistically significant reduction in SRF height and CST could be shown, irrespective of SRF duration, type of CSCR, or chosen guidance after 3 and 6 months: SRF - 40 µm (p < 0.01), CST - 52 µm (p < 0.01). Percentage of eyes with complete resolution of fluid at 3 and 6 months after SML were 24.3 and 21.6%, respectively. No statistically significant functional improvement (VA) could be shown. Multivariable regression and linear mixed regression analyses did not identify statistically significant differences in SRF reduction, CMT change, or VA improvement with respect to the type of CSCR or the treatment plan used (p > 0.05). CONCLUSION The effectiveness of SML in CSCR is under continuous debate. Our study findings demonstrate structural but only little functional changes with SML. In view of the shortage of verteporfin for photodynamic therapy, SML remains an important therapeutic option for CSCR patients.
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Affiliation(s)
- Katrin Fasler
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland
| | - Ferhat Turgut
- Ophthalmology, Stadtspital Zürich Triemli, Zürich, Switzerland
- Ophthalmology, Gutblick Research, Pfäffikon, Switzerland
- Spross Research Institute, Zürich, Switzerland
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Jeanne Martine Gunzinger
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland
- Hunter New England Health, New South Wales, Australia
| | - Chiara Sommer
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland
- Ophthalmology, Stadtspital Zürich Triemli, Zürich, Switzerland
- Spross Research Institute, Zürich, Switzerland
| | - Daniel Rudolf Muth
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland
- Department of Clinical Neuroscience, Division of Eye and Vision, Karolinska Institutet, Stockholm, Sweden
| | - Stephan Kinzl
- Ophthalmology, Stadtspital Zürich Triemli, Zürich, Switzerland
- Spross Research Institute, Zürich, Switzerland
| | - Henning Nilius
- Department of Clinical Chemistry, Inselspital, Bern University Hospital, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Sandrine Zweifel
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland
| | - Gabor Mark Somfai
- Ophthalmology, Stadtspital Zürich Triemli, Zürich, Switzerland
- Spross Research Institute, Zürich, Switzerland
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
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Sharifzadeh Kermani M, Farsi M, Sharifi A, Sardarinia M, Zand A. Central serous chorioretinopathy associated with nonspecific orbital inflammation: a case report. J Int Med Res 2024; 52:3000605241233963. [PMID: 38436326 PMCID: PMC10913497 DOI: 10.1177/03000605241233963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/29/2024] [Indexed: 03/05/2024] Open
Abstract
We herein present a rare case of acute central serous chorioretinopathy (CSC) associated with nonspecific orbital inflammation (NSOI). A 38-year-old woman presented with a 3-day history of ocular pain, reduced vision, periorbital swelling, proptosis, conjunctival chemosis, and restricted eye movements. Optical coherence tomography of the affected eye confirmed signs of CSC. Additionally, a computed tomography scan revealed enlargement of intraconal soft tissues and the lacrimal gland. Ocular ultrasonography detected posterior sclera thickening, indicating posterior scleritis. Following the diagnosis of NSOI, the patient received treatment with systemic corticosteroids, resulting in gradual regression of both the orbital inflammation and CSC. This is the first reported case of localized posterior pole CSC documented in a patient with NSOI. Vigilant monitoring for any ocular disorders is important in patients with orbital inflammation.
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Affiliation(s)
| | - Maryam Farsi
- Department of Ophthalmology, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Sharifi
- Department of Ophthalmology, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahsa Sardarinia
- Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Amin Zand
- Department of Ophthalmology, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
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Kim DI, Bae KW, Jang K, Hwang DDJ. Longitudinal changes in the ganglion cell complex thickness in acute central serous chorioretinopathy using spectral-domain optical coherence tomography. Sci Rep 2024; 14:821. [PMID: 38191653 PMCID: PMC10774394 DOI: 10.1038/s41598-023-50953-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 12/28/2023] [Indexed: 01/10/2024] Open
Abstract
In this retrospective longitudinal cohort study, we investigated the temporal changes in the peripapillary retinal nerve fiber layer (pRNFL) and inner retinal thickness in patients with acute central serous chorioretinopathy (CSC) using spectral-domain optical coherence tomography (SD-OCT). We followed up with these patients for 6 months, and during this period, the thickness of the pRNFL and the ganglion cell complex (GCC) in CSC patients were compared with the eyes of normal healthy individuals. The study also examined the correlation between the pRNFL thickness, GCC thickness, and visual acuity. The research sample consisted of 67 patients (43 male and 24 female) with an average age of 49.72 ± 9.87 years. The initial findings showed no significant differences in the pRNFL and GCC thickness between the study and fellow eye, study and normal healthy eyes, and fellow and normal healthy eyes. There was no significant difference in the pRNFL and GCC thickness when comparing the study eye with the fellow eye for 6 months. In the study eye, no significant difference was observed when comparing the initial GCC and pRNFL thickness with those at 1, 3, and 6 months. Visual acuity improved significantly from 0.18 ± 0.23 logMAR to 0.04 ± 0.06 logMAR (p < 0.001). The GCC and pRNFL thickness did not significantly affect visual acuity. In conclusion, acute CSC patients did not show significant changes in the pRNFL and inner retinal thickness, suggesting that the GCC and pRNFL do not substantially influence the short-term visual prognosis in these patients.
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Affiliation(s)
- Dong Ik Kim
- Department of Ophthalmology, Hangil Eye Hospital, 35 Bupyeong-daero, Bupyeong-gu, Incheon, 21388, South Korea
- Department of Ophthalmology, Catholic Kwandong University College of Medicine, Incheon, South Korea
| | - Ki Woong Bae
- Department of Ophthalmology, Nowon Eulji Medical Center, Seoul, South Korea
- Department of Ophthalmology, Eulji University College of Medicine, Seoul, South Korea
| | - Kyuhwan Jang
- Department of Ophthalmology, Hangil Eye Hospital, 35 Bupyeong-daero, Bupyeong-gu, Incheon, 21388, South Korea
- Department of Ophthalmology, Catholic Kwandong University College of Medicine, Incheon, South Korea
| | - Daniel Duck-Jin Hwang
- Department of Ophthalmology, Hangil Eye Hospital, 35 Bupyeong-daero, Bupyeong-gu, Incheon, 21388, South Korea.
- Department of Ophthalmology, Catholic Kwandong University College of Medicine, Incheon, South Korea.
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Yoon J, Han J, Ko J, Choi S, Park JI, Hwang JS, Han JM, Hwang DDJ. Developing and Evaluating an AI-Based Computer-Aided Diagnosis System for Retinal Disease: Diagnostic Study for Central Serous Chorioretinopathy. J Med Internet Res 2023; 25:e48142. [PMID: 38019564 PMCID: PMC10719821 DOI: 10.2196/48142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 10/29/2023] [Accepted: 11/05/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Although previous research has made substantial progress in developing high-performance artificial intelligence (AI)-based computer-aided diagnosis (AI-CAD) systems in various medical domains, little attention has been paid to developing and evaluating AI-CAD system in ophthalmology, particularly for diagnosing retinal diseases using optical coherence tomography (OCT) images. OBJECTIVE This diagnostic study aimed to determine the usefulness of a proposed AI-CAD system in assisting ophthalmologists with the diagnosis of central serous chorioretinopathy (CSC), which is known to be difficult to diagnose, using OCT images. METHODS For the training and evaluation of the proposed deep learning model, 1693 OCT images were collected and annotated. The data set included 929 and 764 cases of acute and chronic CSC, respectively. In total, 66 ophthalmologists (2 groups: 36 retina and 30 nonretina specialists) participated in the observer performance test. To evaluate the deep learning algorithm used in the proposed AI-CAD system, the training, validation, and test sets were split in an 8:1:1 ratio. Further, 100 randomly sampled OCT images from the test set were used for the observer performance test, and the participants were instructed to select a CSC subtype for each of these images. Each image was provided under different conditions: (1) without AI assistance, (2) with AI assistance with a probability score, and (3) with AI assistance with a probability score and visual evidence heatmap. The sensitivity, specificity, and area under the receiver operating characteristic curve were used to measure the diagnostic performance of the model and ophthalmologists. RESULTS The proposed system achieved a high detection performance (99% of the area under the curve) for CSC, outperforming the 66 ophthalmologists who participated in the observer performance test. In both groups, ophthalmologists with the support of AI assistance with a probability score and visual evidence heatmap achieved the highest mean diagnostic performance compared with that of those subjected to other conditions (without AI assistance or with AI assistance with a probability score). Nonretina specialists achieved expert-level diagnostic performance with the support of the proposed AI-CAD system. CONCLUSIONS Our proposed AI-CAD system improved the diagnosis of CSC by ophthalmologists, which may support decision-making regarding retinal disease detection and alleviate the workload of ophthalmologists.
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Affiliation(s)
- Jeewoo Yoon
- Department of Applied Artificial Intelligence, Sungkyunkwan University, Seoul, Republic of Korea
- Raondata, Seoul, Republic of Korea
| | - Jinyoung Han
- Department of Applied Artificial Intelligence, Sungkyunkwan University, Seoul, Republic of Korea
- Department of Human-Artificial Intelligence Interaction, Sungkyunkwan University, Seoul, Republic of Korea
| | - Junseo Ko
- Department of Applied Artificial Intelligence, Sungkyunkwan University, Seoul, Republic of Korea
- Raondata, Seoul, Republic of Korea
| | - Seong Choi
- Department of Applied Artificial Intelligence, Sungkyunkwan University, Seoul, Republic of Korea
- Raondata, Seoul, Republic of Korea
| | - Ji In Park
- Department of Medicine, Kangwon National University School of Medicine, Kangwon National University Hospital, Chuncheon, Republic of Korea
| | | | - Jeong Mo Han
- Seoul Bombit Eye Clinic, Sejong, Republic of Korea
| | - Daniel Duck-Jin Hwang
- Department of Ophthalmology, Hangil Eye Hospital, Incheon, Republic of Korea
- Lux Mind, Incheon, Republic of Korea
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Suzuki T, Sasajima H, Otaki C, Ueta Y, Tate H. Association of Subretinal Fluid Duration and Baseline Chorioretinal Structure With Optical Coherence Tomography in Central Serous Chorioretinopathy. Transl Vis Sci Technol 2023; 12:12. [PMID: 37831445 PMCID: PMC10587855 DOI: 10.1167/tvst.12.10.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/14/2023] [Indexed: 10/14/2023] Open
Abstract
Purpose This study investigated the association between subretinal fluid (SRF) duration and baseline chorioretinal structure in patients with naïve (first-episode and untreated) central serous chorioretinopathy (CSC). Methods We divided 59 patients into non-prolonged (<3 months) and prolonged (>3 months) groups based on SRF fluid persistence from the initial visit. The follow-up period varied as the shorter duration was chosen between SRF disappearance time and 3 months from the initial visit. We measured the central retinal thickness (CRT), central choroidal thickness (CCT), SRF height (SRFH), and outer nuclear layer thickness (ONL) using spectral-domain optical coherence tomography (SD-OCT) at the initial visit and recorded SRF duration. We compared these parameters between the groups, conducted multivariate analysis for SRF duration of more than 3 months, and investigated the correlation among CCT and CRT, SRFH, or ONL, and among SRF duration and CRT, CCT, SRFH, or ONL. Results CCT was significantly thicker in the prolonged than in the non-prolonged group at the initial visit (P = 0.044) and significantly correlated with CRT and SRFH (P = 0.007, r = 0.35 and P = 0.002, r = 0.39). SRF duration significantly correlated with CRT and SRFH (P = 0.009, r = 0.40 and P = 0.003, r = 0.41). The optimal model for SRF duration more than 3 months included age (P = 0.054) and CCT (P = 0.008). Conclusions Thicker baseline CCT can lead to a longer SRF duration in naïve CSC. Translational Relevance This association aids in early detection of cases at a higher risk of prolonged SRF.
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Affiliation(s)
- Takafumi Suzuki
- Department of Ophthalmology, Shinseikai Toyama Hospital, Imizu, Japan
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
| | - Hirofumi Sasajima
- Department of Ophthalmology, Shinseikai Toyama Hospital, Imizu, Japan
- Yamada Eye Clinic, Nagasaki, Japan
| | - Chisato Otaki
- Department of Ophthalmology, Shinseikai Toyama Hospital, Imizu, Japan
| | - Yoshiki Ueta
- Department of Ophthalmology, Shinseikai Toyama Hospital, Imizu, Japan
| | - Hideo Tate
- Department of Ophthalmology, Shinseikai Toyama Hospital, Imizu, Japan
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Kaya MK, Arslan S. Exploring the Potential Link between Acute Central Serous Chorioretinopathy and Trimethylamine N-Oxide, Phoenixin, Spexin, and Alarin Molecules. Biomolecules 2023; 13:1459. [PMID: 37892139 PMCID: PMC10604309 DOI: 10.3390/biom13101459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/13/2023] [Accepted: 09/20/2023] [Indexed: 10/29/2023] Open
Abstract
PURPOSE Acute central serous chorioretinopathy (ACSCR) is a condition characterized by decreased visual acuity, macular thickening, and edema under the retinal layer. Although the underlying mechanisms of the disease are not fully understood, oxidative stress is considered to be a critical risk factor. The aim of this study was to shed light on the pathophysiology of ACSCR by investigating the levels of circulating trimethylamine N-oxide (TMAO), phoenixin (PNX), alarin (ALA), and spexin (SPX) molecules in ACSCR patients. METHODS The study included 30 ACSCR patients and 30 healthy individuals as controls. ACSCR was diagnosed using optical coherence tomography (OCT) imaging. Five mL blood samples were collected from all participants following overnight fasting. The levels of TMAO, PNX, ALA, and SPX in the blood samples were measured using the ELISA method. RESULTS Visual acuity was found to be significantly reduced in ACSCR patients compared to the control group (<0.05), while macular thickness was increased (<0.05). Furthermore, TMAO, PNX, and ALA levels were significantly higher in ACSCR patients (<0.05), while SPX levels were significantly lower compared to the control group (<0.05). In ACSCR patients, there was a positive correlation between macular thickness and TMAO, PNX, and ALA; there was, however, a negative correlation with SPX. Additionally, visual acuity was negatively correlated with TMAO, PNX, and ALA, while SPX levels decreased as visual acuity decreased. CONCLUSIONS These results demonstrate a correlation between the TMAO, PNX, ALA, and SPX levels of ACSCR patients and their visual acuity and macular thickness. Given the role of these molecules in ACSCR's pathophysiology, they hold promise as potential diagnostic, therapeutic, and follow-up markers in the future.
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Luo Z, Xu Y, Xu K, Fan M, Tsui CK, Lu X, Wu B, Zhao X, Tang X, Wu P, Cui K, Yu S, Liang X. Choroidal Vortex Vein Drainage System in Central Serous Chorioretinopathy Using Ultra-Widefield Optical Coherence Tomography Angiography. Transl Vis Sci Technol 2023; 12:17. [PMID: 37738055 PMCID: PMC10519436 DOI: 10.1167/tvst.12.9.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/28/2023] [Indexed: 09/23/2023] Open
Abstract
Purpose To evaluate differences in the choroidal vortex vein drainage system (VV) in eyes between patients with central serous chorioretinopathy (CSC) and unaffected individuals using ultra-widefield optical coherence tomography angiography (UWF-OCTA). Methods In this cross-sectional observational study, 40 eyes of patients with CSC and 28 eyes of healthy volunteers were included. The analysis involved the use of UWF-OCTA to analyze the proportion of the choroidal vortex vein drainage system (VV%), choroidal thickness, choroidal vascular volume (CVV), and choroidal vascularity index (CVI) of the VV in each drainage quadrant. The location relationship between the leakage points in fluorescein angiography and the VV was also explored. Results A within-group analysis of VV% showed a statistically significant difference in the CSC group (P < 0.001) but not in the control group (P = 0.270). Compared to healthy eyes, CSC eyes had a significantly larger CVV and higher CVI in all regions (all P < 0.05). The superotemporal (ST) drainage system had the largest CVV and thickest choroidal layer among the four drainage quadrants (all P < 0.05) in CSC eyes. The leakage rate in the ST quadrant was significantly higher than that in the inferotemporal quadrant (P < 0.001). Conclusions CSC eyes have an asymmetric vortex vein drainage system, with relative hyperperfusion in all VV. Further, the preferential drainage route of the submacular choroid may be the ST drainage system in CSC eyes. Translational Relevance Targeting the imbalanced drainage system could be a potential therapeutic approach for CSC.
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Affiliation(s)
- Zhonghua Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yue Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Kun Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Matthew Fan
- Yale College, Yale University, New Haven, CT, USA
| | - Ching-Kit Tsui
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xi Lu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Benjuan Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xinyu Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiaoyu Tang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Peiqi Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Kaixuan Cui
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Shanshan Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiaoling Liang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
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Aksu Ceylan N, Cebeci Z. Relationship between macular intervortex vein anastomosis and optical coherence tomography biomarkers in chronic central serous chorioretinopathy. Photodiagnosis Photodyn Ther 2023; 42:103559. [PMID: 37028692 DOI: 10.1016/j.pdpdt.2023.103559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 04/05/2023] [Accepted: 04/05/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUNDS To evaluate the optical coherence tomography (OCT) biomarkers of patients with central serous chorioretinopathy (CSC) according to the presence or absence of direct anatomical relation to intervortex vein anastomosis (IVA) on indocyanine green angiography. METHODS We reviewed the records of 39 patients with chronic CSC. Patients were categorized in 2 groups: presence of IVA(Group A) or absence of IVA(Group B) in the macular region. Localization of IVA was categorized in 3 areas according to ETDRS grid:inner 1 mm circle (area-1), 1-3 mm middle circle (area-2) and 3-6 mm outer circle (area-3). RESULTS There were 31 eyes in Group A,21 eyes in Group B. Mean age of the patients was 52.5 ± 11.3years in Group A,47.2 ± 11years in Group B(p<0.001).Mean initial visual acuity (VA) was 0.38±0.38LogMAR in Group A, 0.19±0.21LogMAR in Group B(p<0.001).Mean subfoveal choroidal thickness(SFCT) was 436.3 ± 134.3µ in Group A,480.2 ± 136.6µ in Group B(p<0.001).Localization of IVA in area-1 was correlated with inner choroidal attenuation (ICA) and leakage on IVA(p = 0.011,p = 0.02). Localization of IVA in area-3 was correlated with irregular lesions on RPE(p = 0.042).Smokestack configuration,intraretinal cysts and ICA were correlated with worse initial VA(p<0.001,p = 0.001 and p = 0.04).Shaggy subtype of photoreceptor disruption was associated with better initial VA(p = 0.003). CONCLUSIONS We detected older age, worse initial VA and thinner SFCT in patients with chronic CSC and macular region IVA(m-IVA). Long term follow-up of patients with and without m-IVA may exhibit the difference in treatment outcomes and development of neovasculopathy.
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Affiliation(s)
- Nihan Aksu Ceylan
- Istanbul University, Istanbul Faculty of Medicine, Department of Ophthalmology, Istanbul, Turkey.
| | - Zafer Cebeci
- Istanbul University, Istanbul Faculty of Medicine, Department of Ophthalmology, Istanbul, Turkey
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Fernández-Vigo JI, Moreno-Morillo FJ, López-Varela E, Novo-Bujan J, Ortega-Hortas M, Burgos-Blasco B, López-Guajardo L, Donate-López J. Repeatability of choriocapillaris flow voids by optical coherence tomography angiography in central serous chorioretinopathy. PLoS One 2022; 17:e0279243. [PMID: 36525424 PMCID: PMC9757554 DOI: 10.1371/journal.pone.0279243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 12/03/2022] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To assess the repeatability of flow signal voids (FSV) measurements of the choriocapillaris (CC) and choroid (CH) in central serous chorioretinopathy (CSCR) by Swept-Source optical coherence tomography angiography (SS-OCTA). METHODS Cross-sectional study including 104 eyes of 52 patients with unilateral CSCR. Two consecutive macular 6x6 mm SS-OCTA scans (Plex Elite 9000; Zeiss, Dublin, CA) were obtained from the affected eyes with persistent subretinal fluid (SRF) (CSCR group) and the fellow unaffected eyes (control group). FSV area and the number of contours measurements were analyzed using three slabs: inner CC, outer CC and CH. The repeatability of the measurements was assessed with intraclass correlation coefficients (ICC) and coefficients of variation (CV). RESULTS In the CSCR group, ICCs for the FSV area in the three slabs were all ≥0.859, observing higher values for the outer CC and the CH (0.959 and 0.964) than for the inner CC (0.859). Similar ICC values were obtained for the FSV area in control eyes, observing the highest values for the outer CC (0.949), followed by the CH (0.932) and inner CC (0.844). Regarding the FSV number of contours measurements, ICCs were higher for the outer CC and CH (0.949 and 0.932) than for inner CC (0.844). CV for the FSV area was 4.7%, 3.8% and 8.6% in the CSCR eyes and 4.8%, 3.9% and 9.3% in the control group for the inner CC, outer CC and CH respectively. CONCLUSION SS-OCTA offers good repeatability to quantify macular FSV in CSCR eyes and fellow eyes.
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Affiliation(s)
- José Ignacio Fernández-Vigo
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
- Department of Ophthalmology, Centro Internacional de Oftalmología Avanzada, Madrid, Spain
- * E-mail:
| | | | - Emilio López-Varela
- Department of Computer Science, Centro de Investigacion CITIC, Universidade da Coruña, A Coruña, Spain
- Department of Computer Science, VARPA Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, A Coruña, Spain
| | - Jorge Novo-Bujan
- Department of Computer Science, Centro de Investigacion CITIC, Universidade da Coruña, A Coruña, Spain
- Department of Computer Science, VARPA Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, A Coruña, Spain
| | - Marcos Ortega-Hortas
- Department of Computer Science, Centro de Investigacion CITIC, Universidade da Coruña, A Coruña, Spain
- Department of Computer Science, VARPA Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, A Coruña, Spain
| | - Bárbara Burgos-Blasco
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - Lorenzo López-Guajardo
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - Juan Donate-López
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
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10
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Wang X, Zhang J, Yu R, Zhou L. Comparative study on retinal microvasculature changes between acute and chronic central serous chorioretinopathy. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2022; 47:1075-1081. [PMID: 36097775 PMCID: PMC10950112 DOI: 10.11817/j.issn.1672-7347.2022.210780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Central serous chorioretinopathy (CSC) is generally a common fundus disease in young and middle-aged Asian men. Acute and chronic CSC can lead to different degrees of injury to the retinal blood flow. This study aims to observe and compare the blood flow density in different retinal capillary layers in patients with acute and chronic CSC using optical coherence tomography angiography (OCTA) technology. METHODS Twelve patients with acute CSC and 8 patients with chronic CSC including 12 eyes with acute CSC (acute CSC eye group), 11 eyes with chronic CSC (chronic CSC eye group), and 17 normal eyes (normal eye group) were enrolled in this study. All patients underwent 3 mm×3 mm, 6 mm×6 mm macular OCTA scanning. The retinal microvascu-lature was divided into superficial vascular complexes (SVC), intermediate capillary plexuses (ICP), and deep capillary plexuses (DCP) using the projection resolved-OCTA algorithm. Inner retina includes SVC, ICP, and DCP. The vessel density in each retinal layer and the inner retina were calculated and compared. RESULTS Macular OCTA scanning of 3 mm×3 mm showed that there was no significant difference in blood flow density of SVC and ICP among the 3 groups (both P>0.05); blood flow density of DCP and inner retina in the chronic CSC eye group was significantly lower than that in the acute CSC eye group and the normal eye group (all P<0.05); there was no significant difference in retinal blood flow density of different layer between the acute CSC eye group and the normal eye group (all P>0.05). Macular OCTA scanning of 6 mm×6 mm showed that inner retinal blood flow density of the chronic CSC eye group was significantly lower than that of the acute CSC eye group and the normal eye group (both P<0.05); there was no significant difference in blood flow density of SVC among the 3 groups (P>0.05). CONCLUSIONS The vessel density of DCP and inner retina in the eyes with chronic CSC are significantly reduced, which may result in impaired visual function. Therefore, we recommend that patients with acute CSC should be properly treated to avoid progressing into chronic CSC.
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Affiliation(s)
- Xiaogang Wang
- Department of Cataract, Shanxi Eye Hospital, Taiyuan 030002.
| | - Jie Zhang
- Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha 410011
| | - Renhe Yu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China
| | - Liang Zhou
- Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha 410011.
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11
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Kim YH, Chung YR, Kim C, Lee K, Lee WK. The Association of Pachydrusen Characteristics with Choroidal Thickness and Patient's Age in Polypoidal Choroidal Vasculopathy versus Central Serous Chorioretinopathy. Int J Mol Sci 2022; 23:ijms23158353. [PMID: 35955481 PMCID: PMC9368714 DOI: 10.3390/ijms23158353] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/15/2022] [Accepted: 07/26/2022] [Indexed: 12/16/2022] Open
Abstract
We investigated the relationship between pachydrusen and choroidal thickness and age in eyes with polypoidal choroidal vasculopathy (PCV) and fellow eyes, compared to eyes with central serous chorioretinopathy (CSC). This retrospective study included 89 eyes with PCV and 146 eyes with CSC. The number, location, and shape of the pachydrusen and their association with choroidal thickness and age were analyzed. PCV eyes showed pachydrusen more frequently than eyes with CSC (52% vs. 20%, p < 0.001). Large solitary type and clustered type were more frequent in PCV eyes compared to CSC eyes (p = 0.003 and p = 0.001, respectively). Subfoveal choroidal thickness was associated with pachydrusen in eyes with PCV (odds ratio [OR] 1.006, 95% confidence interval [CI] 1.001−1.011, p = 0.027), while age was associated with pachydrusen in CSC eyes (OR 1.137, 95% CI, 1.073−1.205; p < 0.001). Pachydrusen were localized directly over the pachyvessel on optical coherence tomographic findings in approximately two thirds of PCV eyes and fellow eyes (62% and 67%, respectively). Risk factors for pachydrusen differ according to diseases. The presence of pachydrusen was associated with choroidal thickness in PCV, while the association with age was more prominent in CSC.
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Affiliation(s)
- Young Ho Kim
- Department of Ophthalmology, Korea University College of Medicine, Seoul 02841, Korea;
| | - Yoo-Ri Chung
- Department of Ophthalmology, Ajou University School of Medicine, Suwon 16499, Korea; (Y.-R.C.); (C.K.)
| | - Chungwoon Kim
- Department of Ophthalmology, Ajou University School of Medicine, Suwon 16499, Korea; (Y.-R.C.); (C.K.)
| | - Kihwang Lee
- Department of Ophthalmology, Ajou University School of Medicine, Suwon 16499, Korea; (Y.-R.C.); (C.K.)
- Correspondence: ; Tel.: +82-31-219-7814
| | - Won Ki Lee
- Retina Center, Nune Eye Hospital, Seoul 06198, Korea;
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12
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Ozawa R, Azuma K, Nomura Y, Murata H, Asaoka R, Kitamoto K, Ueda K, Inoue T, Obata R. Association between retinal sensitivity and the presence of quiescent choroidal neovascularization in pachychoroid diseases. PLoS One 2022; 17:e0271543. [PMID: 35881636 PMCID: PMC9321376 DOI: 10.1371/journal.pone.0271543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 07/02/2022] [Indexed: 11/24/2022] Open
Abstract
This study was conducted to examine retinal sensitivity (RS) in eyes with pachychoroid diseases and to analyze its association with the presence or absence of quiescent choroidal neovascularization (CNV), that can be protective against retinal dysfunction or atrophy in other macular diseases such as age-related macular degeneration. A total of 12 eyes of 12 patients aged ≥45 years having the characteristic findings of central serous chorioretinopathy but not presenting any exudative changes were included in this study. Choroidal vascular hyper permeability (CVH) was identified by indocyanine green angiography, and the presence or absence of CNV was evaluated by optical coherence tomography angiography. RS at 68 points was examined by microperimetry. The average RS corresponding to within and outside CVH was compared. The association between the difference in RS and the presence or absence of CNV was also analyzed. CNV was detected in six eyes (50%). In eyes without CNV, the RS within CVH was similar compared with that outside CVH. However, in eyes with CNV, the RS within CVH was significantly decreased compared with that outside CVH. Multiple regression analysis revealed the presence of CNV as an independent factor associated with RS. In eyes with pachychoroid diseases, RS decreased within the CVH area under the coexistence of nonexudative CNV.
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Affiliation(s)
- Rion Ozawa
- Graduate School of Medicine and Faculty of Medicine, Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Keiko Azuma
- Graduate School of Medicine and Faculty of Medicine, Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Yoko Nomura
- Graduate School of Medicine and Faculty of Medicine, Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Murata
- Graduate School of Medicine and Faculty of Medicine, Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Seirei Christopher University, Shizuoka, Japan
| | - Kohdai Kitamoto
- Graduate School of Medicine and Faculty of Medicine, Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Kohei Ueda
- Graduate School of Medicine and Faculty of Medicine, Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Tatsuya Inoue
- Department of Ophthalmology and Micro-Technology, Yokohama City University School of Medicine, Minami-ku, Yokohama, Kanagawa, Japan
| | - Ryo Obata
- Graduate School of Medicine and Faculty of Medicine, Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
- * E-mail:
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Kakihara S, Hirano T, Wakabayashi M, Murata T. Widefield Optical Coherence Tomography Angiography for Pregnancy-Associated Central Serous Chorioretinopathy. Asia Pac J Ophthalmol (Phila) 2022; 11:294. [PMID: 35342172 DOI: 10.1097/apo.0000000000000437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Shinji Kakihara
- From the Department of Ophthalmology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
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14
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Li Y, Jin P, Lu J, Ma L, Qin X. Analysis of Optical Coherence Tomography in Acute versus Chronic Central Serous Chorioretinopathy. Optom Vis Sci 2022; 99:267-273. [PMID: 34897236 DOI: 10.1097/opx.0000000000001846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SIGNIFICANCE Central serous chorioretinopathy (CSC) is a common retinal disease that causes vision loss worldwide. Studying the imaging characteristics of CSC is helpful for the differential diagnosis of diseases. This study analyzed the differences between acute and chronic CSC and provide related information. PURPOSE The aim of this study was to describe the optical coherence tomography features in patients with acute and chronic CSC. METHODS Sixty-two eyes of 56 patients with CSC were included in the study. Optical coherence tomography was performed to observe the image features. The photoreceptor outer-segment (PROS) thickness above the pigment epithelium detachment (PED) coinciding with the leakage point in fundus fluorescein angiography was measured and compared with the mean PROS thickness outside the PED in acute cases. The SPSS 23.0 software (IBM Co., Chicago, IL) was used for statistical analysis. RESULTS Of our 56 patients (62 eyes), 41 (73.21%) were male and 15 (26.79%) were female. There were 53 eyes (85.48%) with acute CSC and 9 eyes (14.52%) with chronic CSC. Besides other common features, the new feature of a high-reflection band in the outer nuclear layer was found to be limited to the macular detachment area. In acute cases, the mean PROS thickness above the retinal pigment epithelium layer protuberance coinciding with the leakage point was 22.7 ± 8.8 μm, which was less than the mean PROS thickness outside the PED at 64.3 ± 21.3 μm (P ≤ .001). CONCLUSIONS The high-reflection band in the outer nuclear layer within the serous neurosensory detachment limited to the macular area was a new finding in CSC patients. This finding can be used as an imaging feature to aid in the diagnosis of CSC.
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Affiliation(s)
- Yanzhen Li
- Department of Ophthalmology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Pengfei Jin
- Department of Ophthalmology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Jianmin Lu
- Department of Ophthalmology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Li Ma
- Department of Ophthalmology, First Affiliated Hospital of Dalian Medical University, Dalian, China
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Abstract
BACKGROUND AND PURPOSE To the best of our knowledge, there is no study of patients with central serous chorioretinopathy associated with chorioretinal folds, since a short mention in Gass' stereoscopic atlas. We report here six cases with this association. METHODS Six patients with both conditions were examined in our institution and underwent fluorescein angiography and optical coherence tomography. RESULTS Patients were 3 men and 3 women, aged 44 years to 82 years. All patients were hyperopic and two received corticosteroids. Fluorescein angiography showed pigmentary changes, diffuse leakage areas typical of chronic central serous chorioretinopathy, and chorioretinal folds mainly located in the upper temporal part of the fundus. Enhanced depth imaging optical coherence tomography was performed in 5 cases and revealed a thick choroid in all cases (mean subfoveal choroidal thickness: 381 µm, range: 280-510 µm). CONCLUSION Although possibly coincidental, the presence of chorioretinal folds in hyperopic central serous chorioretinopathy eyes could be due to the excessive thickness of the choroid in eyes with hyperopia related to short axial length.
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Affiliation(s)
- Salomon Y Cohen
- Ophthalmology Center for Imaging and Laser, Paris, France
- Department of Ophthalmology, University of Paris Est, Creteil, France
| | | | - Alain Gaudric
- Ophthalmology Center for Imaging and Laser, Paris, France
- Department of Ophthalmology, Lariboisière Hospital, APHP and University of Paris-Sorbonne, Paris, France; and
| | - Sarah Mrejen
- Ophthalmology Center for Imaging and Laser, Paris, France
- National Hospital of XV-XX, Paris, France
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16
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Scholz P, Altay L, Sitnilska V, van Dijk EHC, Pereira AM, van Haalen FM, Akhtar I, Boon CJF, Fauser S. SALIVARY ALPHA-AMYLASE LEVELS MAY CORRELATE WITH CENTRAL SEROUS CHORIORETINOPATHY ACTIVITY. Retina 2021; 41:2479-2484. [PMID: 34292222 DOI: 10.1097/iae.0000000000003266] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE To investigate and compare the salivary alpha-amylase (sAA) activity as an indicator of the sympathetic activity and stress response in patients with central serous chorioretinopathy (CSC) and healthy control subjects. METHODS Prospective multicenter case series, including 80 CSC patients and 88 healthy control subjects. Central serous chorioretinopathy status was classified as either active or inactive, depending on the presence of subretinal fluid on optical coherence tomography. Salivary samples were collected in the morning from patients and control subjects of the main cohort and at midnight for the additional cohort. Salivary alpha-amylase activity was determined in all patients and control subjects. RESULTS Morning sAA activity was significantly higher in patients with active CSC compared with inactive CSC (P = 0.049) and to healthy control subjects (P = 0.012). There was no significant difference in sAA activity between patients with inactive CSC and control subjects (P = 1.0). Nocturnal sAA activity did not show any significant difference between patients with active CSC and either inactive CSC or control subjects (P = 0.139). CONCLUSION Morning sAA activity is increased in patients with active CSC, although diurnal rhythmicity is preserved. Measurement of sAA is easy to perform and might be an eligible tool to further investigate the relation between stress and CSC.
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Affiliation(s)
- Paula Scholz
- Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany
| | - Lebriz Altay
- Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany
| | - Vasilena Sitnilska
- Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany
| | - Elon H C van Dijk
- Department of Ophthalmology, Leiden University Medical Center, Leiden, Netherlands
| | - Alberto M Pereira
- Department of Medicine, Division of Endocrinology, and Center for Endocrine Tumors, Leiden University Medical Center, Leiden, Netherlands
| | - Femke M van Haalen
- Department of Medicine, Division of Endocrinology, and Center for Endocrine Tumors, Leiden University Medical Center, Leiden, Netherlands
| | - Isha Akhtar
- Department of Ophthalmology, University of Cologne, Experimental Immunology of the Eye, Cologne, Germany
| | - Camiel J F Boon
- Department of Ophthalmology, Leiden University Medical Center, Leiden, Netherlands
- Department of Ophthalmology, Academic Medical Center, Amsterdam, the Netherlands; and
| | - Sascha Fauser
- Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany
- F. Hoffmann-La Roche, Basel, Switzerland
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17
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Pfau M, van Dijk EHC, van Rijssen TJ, Schmitz-Valckenberg S, Holz FG, Fleckenstein M, Boon CJF. Estimation of current and post-treatment retinal function in chronic central serous chorioretinopathy using artificial intelligence. Sci Rep 2021; 11:20446. [PMID: 34650220 PMCID: PMC8516921 DOI: 10.1038/s41598-021-99977-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/30/2021] [Indexed: 01/13/2023] Open
Abstract
Refined understanding of the association of retinal microstructure with current and future (post-treatment) function in chronic central serous chorioretinopathy (cCSC) may help to identify patients that would benefit most from treatment. In this post-hoc analysis of data from the prospective, randomized PLACE trial (NCT01797861), we aimed to determine the accuracy of AI-based inference of retinal function from retinal morphology in cCSC. Longitudinal spectral-domain optical coherence tomography (SD-OCT) data from 57 eyes of 57 patients from baseline, week 6-8 and month 7-8 post-treatment were segmented using deep-learning software. Fundus-controlled perimetry data were aligned to the SD-OCT data to extract layer thickness and reflectivity values for each test point. Point-wise retinal sensitivity could be inferred with a (leave-one-out) cross-validated mean absolute error (MAE) [95% CI] of 2.93 dB [2.40-3.46] (scenario 1) using random forest regression. With addition of patient-specific baseline data (scenario 2), retinal sensitivity at remaining follow-up visits was estimated even more accurately with a MAE of 1.07 dB [1.06-1.08]. In scenario 3, month 7-8 post-treatment retinal sensitivity was predicted from baseline SD-OCT data with a MAE of 3.38 dB [2.82-3.94]. Our study shows that localized retinal sensitivity can be inferred from retinal structure in cCSC using machine-learning. Especially, prediction of month 7-8 post-treatment sensitivity with consideration of the treatment as explanatory variable constitutes an important step toward personalized treatment decisions in cCSC.
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Affiliation(s)
- Maximilian Pfau
- Department of Ophthalmology, University of Bonn, Bonn, Germany
- National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - Elon H C van Dijk
- Department of Ophthalmology, Leiden University Medical Center, P. O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - Thomas J van Rijssen
- Department of Ophthalmology, Leiden University Medical Center, P. O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - Steffen Schmitz-Valckenberg
- Department of Ophthalmology, University of Bonn, Bonn, Germany
- John A. Moran Eye Center, University of Utah, Utah, USA
| | - Frank G Holz
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | | | - Camiel J F Boon
- Department of Ophthalmology, Leiden University Medical Center, P. O. Box 9600, 2300 RC, Leiden, The Netherlands.
- Department of Ophthalmology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
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Faghihi H, Mahmoudi A, Pour EK, Ebrahimiadib N, Fadakar K, Ghassemi F, Mirshahi A, Khodabande A, Khojasteh H, Bazvand F, Mehrabi Bahar M, Riazi-Esfahani H. Choroidal features in flat irregular pigment epithelial detachment associated with Chronic central serous chorioretinopathy: Avascular versus vascularized. PLoS One 2021; 16:e0257763. [PMID: 34555122 PMCID: PMC8459941 DOI: 10.1371/journal.pone.0257763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/10/2021] [Indexed: 02/02/2023] Open
Abstract
PURPOSE To investigate the differences in the choroidal biomarkers between two forms of flat irregular pigment epithelial detachment (FIPED): avascular (aFIPED) and vascularized (vFIPED) in eyes with chronic central serous chorioretinopathy (CSC). MATERIALS AND METHODS Enhanced depth imaging optical coherence tomography (EDI-OCT) was done in eyes with FIPED correlated to chronic CSC, fellow eyes, and also in healthy eyes from gender- and age-matched subjects. Eyes with FIPED were classified into two subgroups based on optical coherence tomography angiography (OCTA) findings: vFIPED and aFIPED. Different choroidal biomarkers such as subfoveal choroidal thickness (SFCT), total choroidal area (TCA), and choroidal vascular index (CVI) were compared between the groups. RESULTS Forty-four eyes from 42 patients with chronic CSC and FIPED along with 40 eyes from 20 healthy subjects were included. OCTA identified vascularization in 14 eyes in the FIPED group (31.8%). Mean SFCT was higher in the FIPED group compared to two other groups (p = 0.005). In comparison to patients with aFIPED, patients with vFIPED had lower SFCT (p = 0.003) and higher CVI (p = 0.020) based on multivariate analysis. CONCLUSIONS It seems that measurement of CVI along with SFCT may help to differentiate aFIPED from vFIPED in patients with CSC. Further longitudinal studies would be required to confirm the clinical significance of these findings.
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Affiliation(s)
- Hooshang Faghihi
- Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Mahmoudi
- Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Elias Khalili Pour
- Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazanin Ebrahimiadib
- Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kaveh Fadakar
- Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fariba Ghassemi
- Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Mirshahi
- Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Khodabande
- Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Khojasteh
- Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bazvand
- Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hamid Riazi-Esfahani
- Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Docherty G, Sidiqi A, Martens R, Akil H, Navajas EV. CONVERSION OF FOCAL CHOROIDAL EXCAVATION WITH THE ONSET OF CENTRAL SEROUS CHORIORETINOPATHY: REPORT OF 2 CASES AND REVIEW OF THE LITERATURE. Retin Cases Brief Rep 2021; 15:376-385. [PMID: 30489450 DOI: 10.1097/icb.0000000000000833] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To describe two cases of focal choroidal excavation (FCE) conversion in patients with central serous chorioretinopathy. METHODS Case report and literature review of cases of FCE conversion. RESULTS A 35-year-old asymptomatic pregnant patient was found to have conforming FCE on spectral domain optical coherence tomography of the right eye during hydroxychloroquine screening. Three months later, she presented with decreased vision in the right eye and subretinal fluid in both eyes secondary to central serous chorioretinopathy. Spectral domain optical coherence tomography revealed that her FCE had changed to nonconforming type. A 40-year-old male patient was found to have nonconforming FCE and subretinal fluid in his right eye on spectral domain optical coherence tomography. On follow-up, spectral domain optical coherence tomography demonstrated resolution of subretinal fluid and conversion of nonconforming FCE to conforming type. Literature review showed that most cases of FCE remain stable over time. Conversion from nonconforming FCE to conforming type has been described after photodynamic therapy or anti-vascular endothelial growth factor therapy. Conversion from conforming to nonconforming type has been described in 2 cases that developed subretinal fluid in the setting of acute central serous chorioretinopathy. CONCLUSION Our cases and literature review suggest that nonconforming FCE is the result of persistent subretinal fluid. Further studies are necessary to determine whether symptomatic nonconforming SRF needs treatment to reduce subretinal fluid.
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Affiliation(s)
| | - Ahmad Sidiqi
- Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Handan Akil
- Departments of Ophthalmology and Visual Sciences, and
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Xu J, Wan C, Yang W, Zheng B, Yan Z, Shen J. A novel multi-modal fundus image fusion method for guiding the laser surgery of central serous chorioretinopathy. Math Biosci Eng 2021; 18:4797-4816. [PMID: 34198466 DOI: 10.3934/mbe.2021244] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The angiography and color fundus images are of great assistance for the localization of central serous chorioretinopathy (CSCR) lesions. However, it brings much inconvenience to ophthalmologists because of these two modalities working independently in guiding laser surgery. Hence, a novel fundus image fusion method in non-subsampled contourlet transform (NSCT) domain, aiming to integrate the multi-modal CSCR information, is proposed. Specifically, the source images are initially decomposed into high-frequency and low-frequency components based on NSCT. Then, an improved deep learning-based method is employed for the fusion of low-frequency components, which helps to alleviate the tedious process of manually designing fusion rules and enhance the smoothness of the fused images. The fusion of high-frequency components based on pulse-coupled neural network (PCNN) is closely followed to facilitate the integration of detailed information. Finally, the fused images can be obtained by applying an inverse transform on the above fusion components. Qualitative and quantitative experiments demonstrate the proposed scheme is superior to the baseline methods of multi-scale transform (MST) in most cases, which not only implies its potential in multi-modal fundus image fusion, but also expands the research direction of MST-based fusion methods.
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Affiliation(s)
- Jianguo Xu
- College of Mechanical and Electrical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing 210016, China
| | - Cheng Wan
- College of Electronic and Information Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing 210016, China
| | - Weihua Yang
- The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Bo Zheng
- School of Information Engineering, Huzhou University, Huzhou, 313000, China
| | - Zhipeng Yan
- The Affiliated Eye Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Jianxin Shen
- College of Mechanical and Electrical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing 210016, China
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Altunel O, Arifoglu HB. EVALUATION OF RETINAL VESSEL DIAMETERS IN EYES WITH ACTIVE CENTRAL SEROUS CHORIORETINOPATHY. Retina 2021; 41:861-866. [PMID: 32740489 DOI: 10.1097/iae.0000000000002932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the retinal vessel diameters of healthy eyes and active central serous chorioretinopathy (CSC) eyes, and to evaluate possible effect of retinal vessel diameter alterations on the pathogenesis of CSC. METHODS This retrospective study included 39 patients with CSC and 34 healthy individuals. Spectralis optical coherence tomography + HRA with an infrared reflectance image were used to evaluate structure of retinal vessels in the circular region around the optic disc. For each eye, vertical inner and outer diameters of the four major arteries and veins were measured using infrared reflectance images, and vessel wall thicknesses were also calculated based on inner and outer diameters. RESULTS The 304 vessels of the 39 active CSC eyes and 266 vessels of the 34 healthy eyes were used in the analyses. The mean venous wall thickness in active CSC eyes was significantly thicker than that in healthy eyes (40.0 ± 4.9 vs. 33.5 ± 4.1 μm, P = 0.001), whereas the mean venous inner diameter in active CSC eyes was significantly narrower (52.5 ± 9.7 vs. 61.3 ± 8.1 μm, P = 0.001). Also, the mean venous outer diameter was wider in CSC eyes, albeit not significantly (131.1 ± 7.0 vs. 128.5 ± 8.4 μm, P = 0.074). CONCLUSION Our results suggest that the alterations of retinal venous diameters may play a potential role in the pathogenesis of CSC in addition to alterations in choroidal thickness.
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Affiliation(s)
- Orhan Altunel
- Department of Ophthalmology, Kutahya Health Sciences University, Evliya Celebi Education and Research Hospital, Kutahya, Turkey ; and
| | - Hasan Basri Arifoglu
- Department of Ophthalmology, Kayseri City Education and Research Hospital, Kayseri, Turkey
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Ziccardi L, Landi D, De Geronimo D, Barbano L, Giorno P, Marfia GA, Albanese M, Parisi V, Parravano M. Choriocapillaris Integrity in Relapsed Central Serous Chorioretinopathy in a Patient Treated With Fingolimod for Multiple Sclerosis: New Insights From Optical Coherence Tomography Angiography. J Neuroophthalmol 2021; 41:e51-e53. [PMID: 32235227 DOI: 10.1097/wno.0000000000000937] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Lucia Ziccardi
- Neurophysiology of Vision and Neuroophthalmology Unit (LZ, LB, VP), IRCCS-Fondazione Bietti, Rome, Italy; Medical Retina Unit (DDG, PG, MP), IRCCS-Fondazione Bietti, Rome, Italy; and Multiple Sclerosis Clinical and Research Unit (DL, GAM, MA), Department of Systems Medicine, Tor Vergata University, Rome, Italy
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Schimansky S, Wu XN, Egan C, Mohamed Q. Intravitreal ranibizumab for the management of serous maculopathy secondary to optic disc coloboma-associated choroidal neovascularisation. BMJ Case Rep 2021; 14:e235452. [PMID: 33472799 PMCID: PMC10577755 DOI: 10.1136/bcr-2020-235452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2021] [Indexed: 11/03/2022] Open
Abstract
We report the case of a 19-year-old patient with symptomatic unilateral serous maculopathy associated with an optic nerve coloboma. Fluorescein angiography detected a focal late leak at the temporal edge of the coloboma which was later found to correspond with an area of choroidal neovascularisation on optical coherence tomography angiography. A course of intravitreal ranibizumab achieved good clinical and structural response. This report contributes to the evidence that maculopathies associated with cavitary optic nerve anomalies may in some instances result from choroidal neovascularisation. It also highlights the importance of angiography to identify potential choroidal neovascular membranes, particularly in the absence of haemorrhages and neovascular membranes on fundus examination and conventional optical coherence tomography.
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Affiliation(s)
- Sarah Schimansky
- Department of Ophthalmology, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - Xia Ni Wu
- Medical Retina, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Catherine Egan
- Medical Retina, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Faculty of Brain Sciences, University College London Institute of Ophthalmology, London, UK
| | - Quresh Mohamed
- Department of Ophthalmology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
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Maltsev DS, Fomin AV, Kulikov AN, Vasiliev AS. [Evaluation of choriocapillaris with high-speed spectral-domain optical coherence tomography angiography and image averaging]. Vestn Oftalmol 2021; 137:76-84. [PMID: 34156781 DOI: 10.17116/oftalma202113703176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE To study the capabilities of high-speed spectral-domain optical coherence tomography angiography (SD-OCTA) with image averaging in the evaluation of choriocapillaries in healthy individuals and patients with central serous chorioretinopathy (CSC). MATERIAL AND METHODS All participants underwent OCTA examination on the SOLIX tomograph (Optovue, USA) using quadruplicate 3×3 mm scan with image averaging. Image analysis was performed in 9-µm custom slab with Phansalkar auto local threshold algorithm and calculation of flow voids larger than 5000 µm2 and 10 000 µm2. The optimal slab depth was determined in healthy eyes by consecutive analysis of the slabs with a 3-µm shift from zero position to 33 µm below Bruch's membrane. RESULTS The study included 18 eyes of 18 healthy volunteers (40.4±6.0 years old) and 18 fellow eyes of 18 unilateral CSC patients (37.4±10.7 years old). The slab 12 µm below the Bruch's membrane showed the minimal number of flow voids (23.1±7.0 of >5000 µm2 voids per scan) and was chosen for further analysis. The number of flow voids of >5000 µm2 in healthy paired eyes of CSC patients was statistically significantly higher than in the eyes of healthy individuals (32.7±10.7 and 25.3±8.1 voids/scan, respectively; p=0.022). The number of flow voids of >10000 µm2 was also statistically significantly higher in CSC eyes compared to healthy eyes (5.6±3.3 and 3.5±1.9 voids/scan, respectively; p=0.045). There was no statistically significant difference in total area of the voids between the eyes of healthy individuals and CSC patients (96406.1±3924.5 µm2 and 95395.7 ± 3615.1 µm2, respectively; p=0.42). CONCLUSION The optimal settings for choriocapillaris imaging on the SOLIX tomograph include 9-µm slab 9 to 18 µm below the Bruch's membrane. Using a 9-µm slab 12 µm below the Bruch's membrane, a substantial difference was found in choriocapillaris perfusion between eyes of healthy individuals and CSC patients.
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Affiliation(s)
- D S Maltsev
- S.M. Kirov Military Medical Academy, Saint Petersburg, Russia
| | | | - A N Kulikov
- S.M. Kirov Military Medical Academy, Saint Petersburg, Russia
| | - A S Vasiliev
- S.M. Kirov Military Medical Academy, Saint Petersburg, Russia
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Ochinciuc R, Ochinciuc U, Stanca HT, Barac R, Darabus D, Şuţă M, Baltă F, Burcea M. Photoreceptor assessment in focal laser-treated central serous chorioretinopathy using adaptive optics and fundus autofluorescence. Medicine (Baltimore) 2020; 99:e19536. [PMID: 32282703 PMCID: PMC7440316 DOI: 10.1097/md.0000000000019536] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This study analyzed cone density, cone mosaic, and fundus autofluorescence (FAF) images in patients with focal laser-treated central serous chorioretinopathy (CSC).Observational case series.Forty-two eyes of 21 patients with unilateral treated CSC and bilateral best-corrected visual acuity of 1.0 (decimal fraction) were included. FAF and cone mosaic images were obtained in all patients with an adaptive optics fundus camera. Densities were recorded at 20 points throughout the macula, and choroidal thicknesses were measured.Mean choroidal thicknesses were 419.95 ± 110.33 μm in normal eyes, 459.09 ± 90.07 μm in eyes with active CSC, and 438.61 ± 107.57 μm in treated eyes. The highest density of cones in healthy eyes was 38146 cones/mm, with a 5.66-μm intercellular space (IS), at 700 μm temporal to the center. In eyes with treated CSC, the highest density was 32749 cones/mm, with a 6.13-μm IS, at 500 μm nasal to the center. In all quadrants, median values of maximum cone density were significantly higher in healthy eyes (P = .02, P = .003, P = .0001, and P = .001). Three types of lesions were identified on FAF and were correlated with those on cone mosaic images. Strong correlations were detected between the presence of hypoautofluorescent lesions on the first FAF image and a greater difference between maximum values of photoreceptor density (r = 0.46, P = .03), as well as between the presence of hypoautofluorescent lesions and the duration of pathology (r = 0.68, P < .001).The presence of hypoautofluorescent lesions and the duration of pathology were negative prognostic factors in CSC. Laser treatment could prevent photoreceptor loss.
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Affiliation(s)
- Radu Ochinciuc
- Department of Ophthalmology, “Victor Babes” University of Medicine and Pharmacy, Timisoara
| | - Uliana Ochinciuc
- Department of Ophthalmology, “Dr. Carol Davila” Central Military Emergency University Hospital
| | - Horia T. Stanca
- Department of Ophthalmology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Ramona Barac
- Department of Ophthalmology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Diana Darabus
- Department of Ophthalmology, “Victor Babes” University of Medicine and Pharmacy, Timisoara
| | - Marius Şuţă
- Department of Ophthalmology, “Victor Babes” University of Medicine and Pharmacy, Timisoara
| | - Florian Baltă
- Department of Ophthalmology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Marian Burcea
- Department of Ophthalmology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
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Yang HS, Kang TG, Park H, Heo JS, Park J, Lee KS, Choi S. Quantitative evaluation of choriocapillaris using optical coherence tomography and optical coherence tomography angiography in patients with central serous chorioretinopathy after half-dose photodynamic therapy. PLoS One 2020; 15:e0227718. [PMID: 31929582 PMCID: PMC6957295 DOI: 10.1371/journal.pone.0227718] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 12/24/2019] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To quantify the structural and perfusion changes in choriocapillaris in chronic central serous chorioretinopathy after half-dose photodynamic therapy by using spectral-domain optical coherence tomography and optical coherence tomography angiography. METHODS This retrospective interventional case series examined the eyes of patients with central serous chorioretinopathy. Patients underwent full ophthalmic examinations, including spectral-domain optical coherence tomography and angiography, prior to and 1, 3, and 6 months after the treatment. Clinical and tomographic features of the choriocapillaris and choroidal thickness and vascular changes were evaluated by assessing flow signal voids. RESULTS All 56 eyes of 56 patients showed complete resolution of subretinal fluid at 3 months after photodynamic therapy. The best-corrected visual acuity significantly improved at 6 months (p<0.001). The central subfield thickness, subfoveal choroidal thickness, subfoveal choroidal large vessel layer thickness, and mean total area of flow signal voids decreased significantly at 6 months (all p values < 0.001), but the subfoveal choriocapillaris layer thickness did not change significantly at 6 months (p≥0.16). Multivariate analysis revealed positive linear correlations of the central subfield thickness and subfoveal choroidal large vessel layer thickness with the mean total area of flow signal voids at 6 months (p<0.001). There was a negative linear correlation between the subfoveal choriocapillaris layer and the mean total area of flow signal voids at 6 months (p = 0.013). CONCLUSION Half-dose photodynamic therapy improved the anatomic and functional outcomes of central serous chorioretinopathy, induced subfoveal choroidal thickness thinning, and increased choriocapillaris perfusion. In addition, the recovery of the subfoveal choriocapillaris layer thickness and improved choriocapillaris perfusion were closely associated.
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Affiliation(s)
- Hyun Seung Yang
- Department of Ophthalmology, Seoul Shinsegae Eye Center, Eui Jung Bu, Gyeonggi-do, South Korea
| | - Tae Gu Kang
- Department of Ophthalmology, Veterans Health Service Medical Center, Seoul, South Korea
| | - Hyun Park
- Department of Endocrinology, Seoul Chuk Hospital, Eui Jung Bu, Gyeonggi-do, South Korea
| | - Ji Su Heo
- Department of Ophthalmology, Seoul Shinsegae Eye Center, Eui Jung Bu, Gyeonggi-do, South Korea
| | - Jonghoon Park
- Department of Ophthalmology, Seoul Shinsegae Eye Center, Eui Jung Bu, Gyeonggi-do, South Korea
| | - Kyung Sub Lee
- Department of Ophthalmology, Seoul Shinsegae Eye Center, Eui Jung Bu, Gyeonggi-do, South Korea
| | - Sangkyung Choi
- Department of Ophthalmology, Veterans Health Service Medical Center, Seoul, South Korea
- * E-mail:
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Gao K, Niu S, Ji Z, Wu M, Chen Q, Xu R, Yuan S, Fan W, Chen Y, Dong J. Double-branched and area-constraint fully convolutional networks for automated serous retinal detachment segmentation in SD-OCT images. Comput Methods Programs Biomed 2019; 176:69-80. [PMID: 31200913 DOI: 10.1016/j.cmpb.2019.04.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 04/17/2019] [Accepted: 04/23/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND AND OBJECTIVE Quantitative assessment of subretinal fluid in spectral domain optical coherence tomography (SD-OCT) images is crucial for the diagnosis of central serous chorioretinopathy. For the subretinal fluid segmentation, the traditional methods need to segment retinal layers and then segment subretinal fluid. The layer segmentation has a high influence on subretinal fluid segmentation, so we aim to develop a deep learning model to segment subretinal fluid automatically without layer segmentation. METHODS In this paper, we propose a novel image-to-image double-branched and area-constraint fully convolutional networks (DA-FCN) for segmenting subretinal fluid in SD-OCT images. Firstly, the dataset is extended by mirroring image, which helps to overcome the over-fitting problem in the training stage. Then, double-branched structures are designed to learn the shallow coarse and deep representations from the SD-OCT images. DA-FCN model is directly trained using the image and corresponding pixel-based ground truth. Finally, we introduce a novel supervision mechanism by jointing the area loss LA with the softmax loss LS to learn more representative features. RESULTS The testing dataset with 52 SD-OCT volumes from 35 eyes of 35 patients is used for the evaluation of the proposed algorithm based on the cross-validation method. For the three criterions, including the true positive volume fraction, dice similarity coefficient, and positive predicative value, our method can obtain the results of (1) 94.3, 95.3, and 96.4 for dataset 1; (2) 97.3, 95.3, and 93.4 for dataset 2; (3) 93.0, 92.8, and 92.8 for dataset 3; (4) 89.7, 90.1, and 92.6 for dataset 4. CONCLUSION In this work, we propose a novel fully convolutional network for the automatic segmentation of the subretinal fluid. By constructing the double branched structures and area constraint term, our method shows higher segmentation accuracy without layer segmentation compared with other methods.
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Affiliation(s)
- Kun Gao
- Shandong Provincial Key Laboratory of Network based Intelligent Computing, School of Information Science and Engineering, University of Jinan, Jinan 250022, China
| | - Sijie Niu
- Shandong Provincial Key Laboratory of Network based Intelligent Computing, School of Information Science and Engineering, University of Jinan, Jinan 250022, China.
| | - Zexuan Ji
- School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing 210094, China
| | - Menglin Wu
- School of Computer Science and Technology, Nanjing Tech University, Nanjing 210094, China
| | - Qiang Chen
- School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing 210094, China
| | - Rongbin Xu
- Shandong Provincial Key Laboratory of Network based Intelligent Computing, School of Information Science and Engineering, University of Jinan, Jinan 250022, China
| | - Songtao Yuan
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210094, China
| | - Wen Fan
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210094, China
| | - Yuehui Chen
- Shandong Provincial Key Laboratory of Network based Intelligent Computing, School of Information Science and Engineering, University of Jinan, Jinan 250022, China
| | - Jiwen Dong
- Shandong Provincial Key Laboratory of Network based Intelligent Computing, School of Information Science and Engineering, University of Jinan, Jinan 250022, China
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Schellevis RL, Breukink MB, Gilissen C, Boon CJF, Hoyng CB, de Jong EK, den Hollander AI. Exome sequencing in patients with chronic central serous chorioretinopathy. Sci Rep 2019; 9:6598. [PMID: 31036833 PMCID: PMC6488596 DOI: 10.1038/s41598-019-43152-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 04/17/2019] [Indexed: 01/19/2023] Open
Abstract
Chronic central serous chorioretinopathy (cCSC) is a multifactorial eye disease characterized by subretinal fluid accumulation that leads to vision loss. Clinically, cCSC is associated with stress, hypercortisolism and corticosteroid use, and is more frequent in males (80%) than in females (20%). Current genetic studies on cCSC have thus far focussed on common variants, but familial occurrence of cCSC also suggests a role for rare variants in the disease susceptibility. Therefore, in this study, we performed exome sequencing of cCSC patients to elucidate the role of rare (protein-altering) variants in the disease. Exome sequencing was performed on 269 cCSC patients and 1,586 controls. Data were processed according to the Genome-Analysis-Toolkit (GATK) best practices. Principal component analysis was performed to check for genetic ancestry and only unrelated subjects of European descent were retained. Burden, SKAT and SKAT-O tests were performed using 2 different grouping criteria. One group included protein-altering variants only, while the other contained synonymous and splice site variants as well. The gene-based analyses were performed using the SKAT R-package correcting for two principal components using two approaches; (1) on the entire cohort correcting for sex and (2) on males and females separately. Additionally, the gene-based associations of genes at previously reported cCSC loci were investigated. After filtering, the dataset contained 263 cCSC patients (208 males [79%]) and 1352 controls (671 males [50%]) carrying 197,915 protein-altering variants in 16,370 genes and 330,689 exonic variants in 18,173 genes. Analysis stratified by sex identified significant associations with the PIGZ (PSKAT = 9.19 × 10-7 & PSKAT-O = 2.48 × 10-6), DUOX1 (PSKAT = 1.03 × 10-6), RSAD1 (PSKAT = 1.92 × 10-7 & PSKAT-O = 8.57 × 10-8) and LAMB3 (PBurden = 1.40 × 10-6 & PSKAT-O = 1.14 × 10-6) genes in female cCSC patients, after correction for multiple testing. The number of rare variant carriers in these genes was significantly higher in the female cCSC cohort compared to female controls (45,5% vs. 18.5%, P = 1.92 × 10-6, OR = 3.67 [95% CI = 2.09-6.46]). No significant associations were identified in the entire cohort nor in the male patients. In this exome study on cCSC patients, we have identified PIGZ, DUOX1, RSAD1 and LAMB3 as potential new candidate genes for cCSC in females. The sex-specific associations identified here suggest a possible interaction between rare genetic factors and sex for cCSC, but replication of these findings in additional cohorts of cCSC patients is necessary.
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Affiliation(s)
- Rosa L Schellevis
- Department of Ophthalmology, Donders Institute of Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Myrte B Breukink
- Department of Ophthalmology, Donders Institute of Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Christian Gilissen
- Department of Genetics, Donders Institute of Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Camiel J F Boon
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Carel B Hoyng
- Department of Ophthalmology, Donders Institute of Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Eiko K de Jong
- Department of Ophthalmology, Donders Institute of Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anneke I den Hollander
- Department of Ophthalmology, Donders Institute of Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
- Department of Genetics, Donders Institute of Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
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Kishi S, Matsumoto H, Sonoda S, Hiroe T, Sakamoto T, Akiyama H. Geographic filling delay of the choriocapillaris in the region of dilated asymmetric vortex veins in central serous chorioretinopathy. PLoS One 2018; 13:e0206646. [PMID: 30412594 PMCID: PMC6226146 DOI: 10.1371/journal.pone.0206646] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 10/16/2018] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To investigate the correlation between geographic filling delays in the choriocapillaris using indocyanine green angiography (ICGA) images and dilated vortex veins in central serous chorioretinopathy (CSC). DESIGN Observational case series. PARTICIPANTS Thirty-two eyes of 32 patients, 21 with acute and 11 with chronic CSC. METHODS Digital ICGA and fluorescein angiography (FA), with videoangiography, and swept-source optical coherence tomography (SS-OCT) for B-scan and en-face choroidal imaging were performed. Overlapping of the filling delay areas in the choriocapillaris in the early-phase ICGA images and the region of dilated vortex veins in the en-face images were analyzed. The consistency of both areas was graded as follows. Grade 3: filling delay area is entirely involved in the dilated vortex vein region. Grade 2: 50% or more of filling delay area overlaps with the dilated vortex vein region. Grade 1: less than 50% of filling delay area overlaps with the dilated vortex vein region. Grade 0: no tendency for overlapping of two areas. We evaluated the asymmetry of upper and lower vortex veins in en-face images of the Haller layer. Using the binarization method, we quantified the luminal and stromal areas of the choroid. The ratios of the Haller layer area and luminal areas in the Haller layer to total choroidal area were examined. RESULTS The consistency of overlapping of the two areas was grade 2.62 ± 0.49 in acute CSC and grade 1.55 ± 0.78 in chronic CSC (p = 0.0005). Asymmetry of upper and lower vortex veins was seen in 17 of 22 eyes (81%) with acute CSC and 6 of 11 eyes (54.5%) with chronic CSC (p = 0.114). Central choroidal thickness was 411 ± 79 μm in acute CSC and 326 ± 64 μm in chronic CSC (p = 0.004). In the posterior fundus with a 4500 μm diameter, the ratio of the Haller layer area to total choroidal area was 63.7 ± 8.6% in acute CSC and 57.1 ± 7.9% in chronic CSC (p = 0.047). The ratio of the luminal area in the Haller layer area to total choroidal area was 46.9 ± 7.6% in acute CSC and 40.0 ± 6.9% in chronic CSC (p = 0.014). CONCLUSION Filling delay areas in the choriocapillaris and dilated vortex vein regions showed marked overlapping in acute CSC. Increased choroidal thickness was attributed to dilated vortex veins. These findings suggest that the blood flow into the choriocapillaris is delayed as a result of congestion of the dominant vortex veins that supply this geographic area. CSC may be a disease characterized by vortex vein congestion that develops in eyes with asymmetric vortex veins.
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Affiliation(s)
- Shoji Kishi
- Maebashi Central Eye Clinic, Maebashi, Japan
| | - Hidetaka Matsumoto
- Department of Ophthalmology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Shozo Sonoda
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takashi Hiroe
- Department of Ophthalmology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Taiji Sakamoto
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hideo Akiyama
- Department of Ophthalmology, Gunma University Graduate School of Medicine, Maebashi, Japan
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Yumusak E, Gokcinar NB, Ornek K. Choroidal thickness changes in non-treated acute and ranibizumab-treated chronic central serous chorioretinopathy. Medicine (Baltimore) 2018; 97:e12885. [PMID: 30412084 PMCID: PMC6221658 DOI: 10.1097/md.0000000000012885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To evaluate the changes in subfoveal retinal, and choroidal thicknesses (CT) in the non-treated acute and the ranibizumab-treated chronic central serous chorioretinopathy (CSCR) patients.This retrospective study included 32 eyes of 32 consecutive patients with CSCR. There were 12 patients who presented with a spontaneous resolution of CSCR (Group 1) and 20 patients who were treated with ranibizumab for persistent subretinal fluid (SRF) (Group 2). Optical coherence tomography (OCT) imaging of subfoveal retinal thickness and enhanced depth imaging OCT of CT at subfoveal; at nasal and temporal 500 μm (T500); at nasal and temporal 1500 μm (T1500) were analyzed. The Student t test and multivariate analysis were used to compare variables within and between groups, respectively and correlations were analyzed using Pearson correlation coefficient. A P value of P < .05 was accepted as significant.The mean patient age was 38.94 ± 8.41 years (range, 20-53 years). Female/male ratio was 4/28. The mean duration of follow-up was 21.6 ± 8.2 months in the chronic CSCR group. Visual acuity improved and central foveal thickness (FT) decreased significantly in both groups. CT decreased significantly only at nasal 1500 μm (N1500) in the acute group and at all measured points in the chronic group compared with baseline, except at T500 (P = .07). No significant difference in central FT was detected between the 2 groups. Compared with the acute group, baseline subfoveal CT was significantly higher in chronic patients. There was a significant difference between the groups in baseline and final CT at T500. No significant difference was found at T1500. At nasal 500 μm and N1500, the difference between the groups was significant only for final CT values.Chronic CSCR was associated with higher baseline CT values in the subfoveal region and at T500. CT significantly decreased at most of the measured points in ranibizumab-treated chronic CSCR patients, whereas it significantly decreased only at 1 point in spontaneously resolved acute CSCR patients.
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Affiliation(s)
- Erhan Yumusak
- Kirikkale University, School of Medicine, Department of Ophthalmology, Kirikkale
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Ma DJ, Park UC, Kim ET, Yu HG. Choroidal vascularity changes in idiopathic central serous chorioretinopathy after half-fluence photodynamic therapy. PLoS One 2018; 13:e0202930. [PMID: 30148858 PMCID: PMC6110491 DOI: 10.1371/journal.pone.0202930] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Accepted: 08/10/2018] [Indexed: 12/26/2022] Open
Abstract
PURPOSE This study evaluated changes in choroidal vascularity after half-fluence photodynamic therapy (HF-PDT) in patients with central serous chorioretinopathy (CSC) using swept-source optical coherence tomography (SS-OCT) en face imaging. METHODS This retrospective comparative case series included 50 eyes of 25 patients with unilateral CSC who underwent HF-PDT and 50 age-and sex-matched normal healthy control eyes. En face SS-OCT images of the choriocapillaris, Sattler's layer, and Haller's layer were converted into binary images. The vascular proportions were defined as the percentage of the area of vascular lumen against the area of the 3.0-mm-diameter circular area. The main outcome measures were the vascular proportions before HF-PDT and at 6 weeks, 6 months, and 12 months after HF-PDT. RESULTS At baseline, the vascular proportions in the CSC eyes were significantly greater than those in the control eyes in all layers (choriocapillaris: 51.8% ± 15.5% vs. 41.3 ± 18.7%, P = 0.018; Sattler's: 58.6% ± 13.4% vs. 49.7% ± 15.7%, P = 0.017; Haller's: 65.3% ± 15.3% vs. 53.0% ± 13.4%, P = 0.001). In the CSC eyes, the vascular proportion in the choriocapillaris significantly decreased at 6 weeks (36.6% ± 16.9%, P < 0.001), 6 months (34.0% ± 12.3%, P < 0.001), and 12 months (34.8% ± 17.6%, P < 0.001) after HF-PDT compared with baseline. The vascular proportions in Sattler's and Haller's layers did not show a significant decrease at 6 weeks (Sattler's: 49.7% ± 17.3%, P = 0.052 and Haller's: 58.3% ± 12.9%, P = 0.558) but decreased significantly at 6 months (Sattler's: 48.9% ± 12.4%, P < 0.001 and Haller's: 57.7% ± 15.7%, P = 0.027) and 12 months after HF-PDT from the baseline values (Sattler's: 45.8% ± 10.4%, P < 0.001 and Haller's: 56.8% ± 15.7%, P < 0.001). CONCLUSION After HF-PDT, the choriocapillaris showed the earliest decrease in vascular proportion of en face images, Sattler's and Haller's layers showed later decreases. The temporal differences in the response of each layer may reflect the pathophysiology of CSC and the therapeutic mechanism of HF-PDT.
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Affiliation(s)
- Dae Joong Ma
- Department of Ophthalmology, College of Medicine, Seoul National University, Seoul, Republic of Korea
- Retinal Degeneration Research Laboratory, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
| | - Un Chul Park
- Department of Ophthalmology, College of Medicine, Seoul National University, Seoul, Republic of Korea
- Retinal Degeneration Research Laboratory, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
| | - Ei Tae Kim
- Department of Ophthalmology, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Hyeong Gon Yu
- Department of Ophthalmology, College of Medicine, Seoul National University, Seoul, Republic of Korea
- Retinal Degeneration Research Laboratory, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea
- * E-mail:
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van Rijssen TJ, Mohabati D, Dijkman G, Theelen T, de Jong EK, van Dijk EHC, Boon CJF. Correlation between redefined optical coherence tomography parameters and best-corrected visual acuity in non-resolving central serous chorioretinopathy treated with half-dose photodynamic therapy. PLoS One 2018; 13:e0202549. [PMID: 30142176 PMCID: PMC6108462 DOI: 10.1371/journal.pone.0202549] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 07/16/2018] [Indexed: 01/27/2023] Open
Abstract
Purpose To assess parameters on optical coherence tomography (OCT), and their correlation with best-corrected visual acuity (BCVA) in patients with non-resolving central serous chorioretinopathy (CSC). Methods For 25 non-resolving CSC patients treated with photodynamic therapy (PDT), the thickness of retinal layers was assessed on the foveal spectral-domain (SD) OCT scan. Evaluated OCT parameters included the central retinal thickness (CRT), defined as the internal limiting membrane (ILM) to ellipsoid zone (EZ) distance, and the second band thickness (SBT), defined as the EZ to hyperreflective subretinal accumulation distance. Integrity of the external limiting membrane (ELM) and the EZ bands was also determined. These parameters, along with BCVA and CRT measured automatically by SD-OCT device software were obtained before PDT, after PDT, and at final visit. After Bonferroni correction, a p-value <0.007 was considered statistically significant. Results Twenty-five patients could be included at last visit before PDT and first visit after PDT. At final visit, 24 patients could be included, since 1 patients was lost to follow-up. Mean CRT was 112 μm at last visit before PDT, 118 μm at first visit after PDT (p = 0.030), and 127 μm at final visit (p<0.001compared to baseline). Mean SBT was 74 μm, 26 μm (p<0.001 compared to baseline), and 21 μm (p<0.001 compared to baseline), respectively. Mean BCVA in Early Treatment of Diabetic Retinopathy Study letters was 79 at baseline, 85 at first visit after PDT (p = 0.005 compared to baseline), and 87 at final visit (p = 0.001 compared to baseline). BCVA had an estimated correlation of β = 0.103 (p = 0.114) with CRT, β = -0.051 (p = 0.014) with SBT, β = 0.615 (p = 0.600) with the integrity of the ELM, and β = 4.917 with the integrity of the EZ (p = 0.001). Conclusions In non-resolving CSC patients treated with half-dose PDT, the CRT increased at final visit in comparison to the last visit before PDT. The continuity of the EZ on SD-OCT was positively correlated with BCVA. We propose that the distance between ILM and EZ should be used as a reliable CRT measurement in non-resolving CSC patients treated with half-dose PDT.
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Affiliation(s)
- Thomas J. van Rijssen
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Danial Mohabati
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Greet Dijkman
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Thomas Theelen
- Department of Ophthalmology, Donders Institute of Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Eiko K. de Jong
- Department of Ophthalmology, Donders Institute of Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Elon H. C. van Dijk
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Camiel J. F. Boon
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Ophthalmology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- * E-mail:
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Stepanov A, Studnička J, Středová M, Jirásková N. Pachychoroid disease of the macula. Cesk Slov Oftalmol 2018; 74:3-8. [PMID: 30541290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Progress in optical coherent tomography (OCT) has recently provided new insights into variety of chorioretinal disorders. The use of EDI (Enhanced Depth Imaging) during OCT examinations and as well as OCT angiography provides a more accurate analysis of the choroid both quantitatively and qualitatively. "Pachychoroid" (greek pachy- [παχύ] - thick) is defined as an abnormal and sustained increase in choroidal thickness 300 μm, which is mainly due to dilated choroidal vessels in the Hallers layer and other structural changes in physiological choroidal architecture. Central serous chorioretinopathy is one of many macular diseases associated with "pachychoroid". Another diseases that belong to the group of macular pachychoroid disorders are: pachychoroid pigment epitelopathy, pachychoroid neovasculopathy, polypoid choroidal vasculopathy. In this paper we summarize the current view on pachychoroid macular diseases and describe characteristics that are observed in multimodal imaging analysis of choroidal changes. Key words: optical koherence tomography, OCT, pachychoroid, EDI scan.
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Gattoussi S, Freund KB. Multimodal Imaging in Central Serous Chorioretinopathy. Ophthalmology 2017; 124:1331. [PMID: 28823348 DOI: 10.1016/j.ophtha.2017.02.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 02/13/2017] [Accepted: 02/13/2017] [Indexed: 11/18/2022] Open
Affiliation(s)
- Sarra Gattoussi
- Vitreous Retina Macula Consultants of New York, New York, New York
| | - K Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, New York
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de la Cruz-Merino L, Di Guardo L, Grob JJ, Venosa A, Larkin J, McArthur GA, Ribas A, Ascierto PA, Evans JTR, Gomez-Escobar A, Barteselli G, Eng S, Hsu JJ, Uyei A, Dréno B. Clinical features of serous retinopathy observed with cobimetinib in patients with BRAF-mutated melanoma treated in the randomized coBRIM study. J Transl Med 2017; 15:146. [PMID: 28646893 PMCID: PMC5483259 DOI: 10.1186/s12967-017-1246-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 06/15/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Serous chorioretinopathy has been associated with MEK inhibitors, including cobimetinib. We describe the clinical features of serous retinopathy observed with cobimetinib in patients with BRAF V600-mutated melanoma treated in the Phase III coBRIM study. METHODS In the coBRIM study, 493 patients were treated in two randomly assigned treatment groups: cobimetinib and vemurafenib (n = 247) or vemurafenib (n = 246). All patients underwent prospective ophthalmic examinations at screening, at regular intervals during the study, and whenever ocular symptoms developed. Patients with serous retinopathy were identified in the study database using a group of relevant and synonymous adverse event terms. RESULTS Eighty-six serous retinopathy events were reported in 70 patients (79 events in 63 cobimetinib and vemurafenib-treated patients vs seven events in seven vemurafenib-treated patients). Most patients with serous retinopathy identified by ophthalmic examination had no symptoms or had mild symptoms, among them reduced visual acuity, blurred vision, dyschromatopsia, and photophobia. Serous retinopathy usually occurred early during cobimetinib and vemurafenib treatment; median time to onset was 1.0 month. Most events were managed by observation and continuation of cobimetinib without dose modification and resolved or were resolving by the data cutoff date (19 Sept 2014). CONCLUSIONS Cobimetinib treatment was associated with serous retinopathy in patients with BRAF V600-mutated melanoma. Retinopathy was generally asymptomatic or mild. Periodic ophthalmologic evaluations at regular intervals and at the manifestation of any visual disturbance are recommended to facilitate early detection and resolution of serous retinopathy while patients are taking cobimetinib. Trial Registration Clinicaltrials.gov (NCT01689519). First received: September 18, 2012.
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Affiliation(s)
- Luis de la Cruz-Merino
- Servicio de Oncología Médica, Hospital Universitario Virgen Macarena, Avenida Doctor Fedriani 3, 41071 Seville, Spain
| | | | | | | | | | - Grant A. McArthur
- Peter MacCallum Cancer Centre, East Melbourne, VIC Australia
- University of Melbourne, Parkville, VIC Australia
| | - Antoni Ribas
- Jonsson Comprehensive Cancer Center at the University of California, Los Angeles, CA USA
| | | | | | - Antonio Gomez-Escobar
- Servicio de Oncología Médica, Hospital Universitario Virgen Macarena, Avenida Doctor Fedriani 3, 41071 Seville, Spain
| | | | - Susan Eng
- Genentech, Inc., South San Francisco, CA USA
| | | | - Anne Uyei
- Genentech, Inc., South San Francisco, CA USA
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Kim N, Escobar Martin E, Gili Manzanaro P. Posterior pole vortex veins in central serous chorioretinopathy. Arch Soc Esp Oftalmol 2017; 92:e34. [PMID: 27743618 DOI: 10.1016/j.oftal.2016.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 08/20/2016] [Indexed: 06/06/2023]
Affiliation(s)
- N Kim
- Servicio de Oftalmología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España.
| | - E Escobar Martin
- Servicio de Oftalmología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - P Gili Manzanaro
- Servicio de Oftalmología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
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Wu M, Chen Q, He X, Li P, Fan W, Yuan S, Park H. Automatic Subretinal Fluid Segmentation of Retinal SD-OCT Images With Neurosensory Retinal Detachment Guided by Enface Fundus Imaging. IEEE Trans Biomed Eng 2017; 65:87-95. [PMID: 28436839 DOI: 10.1109/tbme.2017.2695461] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Accurate segmentation of neurosensory retinal detachment (NRD) associated subretinal fluid in spectral domain optical coherence tomography (SD-OCT) is vital for the assessment of central serous chorioretinopathy (CSC). A novel two-stage segmentation algorithm was proposed, guided by Enface fundus imaging. METHODS In the first stage, Enface fundus image was segmented using thickness map prior to detecting the fluid-associated abnormalities with diffuse boundaries. In the second stage, the locations of the abnormalities were used to restrict the spatial extent of the fluid region, and a fuzzy level set method with a spatial smoothness constraint was applied to subretinal fluid segmentation in the SD-OCT scans. RESULTS Experimental results from 31 retinal SD-OCT volumes with CSC demonstrate that our method can achieve a true positive volume fraction (TPVF), false positive volume fraction (FPVF), and positive predicative value (PPV) of 94.3%, 0.97%, and 93.6%, respectively, for NRD regions. Our approach can also discriminate NRD-associated subretinal fluid from subretinal pigment epithelium fluid associated with pigment epithelial detachment with a TPVF, FPVF, and PPV of 93.8%, 0.40%, and 90.5%, respectively. CONCLUSION We report a fully automatic method for the segmentation of subretinal fluid. SIGNIFICANCE Our method shows the potential to improve clinical therapy for CSC.
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Ben Salem S, Sithom A, Ben Dhia I, Khelifi T, Askri H, Ayed A. Central serous chorioretinopathy after nasal corticosteroids in the aviator. Tunis Med 2016; 94:695. [PMID: 28994874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Abstract
BACKGROUND Central serous chorioretinopathy (CSC) is usually a self-limiting condition; however, there is potential for recurrence and permanent visual defects. Aviation demands perfect vision to minimize risk to pilots and aircraft. Consequently, this ailment disqualifies pilots and pilots to be. CASE REPORT A fully trained fighter pilot with 1260 h in fighter airframes has been contending with central serous chorioretinopathy in the right eye over the course of 3 yr. The condition was diagnosed after the member presented with visual disturbances. His course was followed with multiple treatment modalities: watchful waiting, micropulse laser, and rifampin. His disease responded well with rifampin, but was ultimately stopped secondary to elevated liver enzymes. Micropulse laser failed to resolve subretinal fluid. Ultimately the pilot is left with a chronic area of CSC without visual defects and faces career termination. DISCUSSION Uncompromised vision is inherently crucial in aerospace careers, especially that of a fighter pilot. With persistent CSC resistant to treatment, there is a risk for progression to permanent visual disturbances and/or defects. Safety concerns of authority figures overseeing pilots and aircraft are warranted. However, the concern could be mitigated in air frames that require two pilots. Another factor partially responsible for ending his career is the fear of G force affecting his prognosis. The author is not aware of any other studies illuminating the effects or consideration of excess G force on subretinal fluid in CSC. This is an area that requires further study. Dietrich KC. Fighter pilot with recurrent central serous chorioretinopathy. Aerosp Med Hum Perform. 2016; 87(10):901-905.
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Gawecki M, Groszewska E. Central serous chorioretinopathy during pregnancy complicated by systemic hypertension - a case report. Klin Oczna 2016; 117:256-259. [PMID: 29727113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We present a case of a pregnant woman with pregnancy induced systemic hypertension who developed bilateral central serous chorioretinopathy diagnosed after caesarean delivery. Central serous chorioretinopathy can occur in the third trimester of pregnancy and generally has a benign course and good prognosis. Our patient ended up with significant and permanent visual impairment in one eye. Probably in some cases, early ophthalmic diagnostic management, including optical coherence tomography could help identify patients at risk of pemanent visual impairment due to chronic central serous chorioretinopathy and assess their eligibility for subtreshold micropulse laser treatment.
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Melzer C, Holz FG, Schmitz-Valckenberg S. [Bilateral retinal detachment]. Ophthalmologe 2016; 114:70-73. [PMID: 27255530 DOI: 10.1007/s00347-016-0277-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- C Melzer
- Universitäts-Augenklinik Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Deutschland.
| | - F G Holz
- Universitäts-Augenklinik Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Deutschland
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Hassan B, Raja G, Hassan T, Usman Akram M. Structure tensor based automated detection of macular edema and central serous retinopathy using optical coherence tomography images. J Opt Soc Am A Opt Image Sci Vis 2016; 33:455-63. [PMID: 27140751 DOI: 10.1364/josaa.33.000455] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Macular edema (ME) and central serous retinopathy (CSR) are two macular diseases that affect the central vision of a person if they are left untreated. Optical coherence tomography (OCT) imaging is the latest eye examination technique that shows a cross-sectional region of the retinal layers and that can be used to detect many retinal disorders in an early stage. Many researchers have done clinical studies on ME and CSR and reported significant findings in macular OCT scans. However, this paper proposes an automated method for the classification of ME and CSR from OCT images using a support vector machine (SVM) classifier. Five distinct features (three based on the thickness profiles of the sub-retinal layers and two based on cyst fluids within the sub-retinal layers) are extracted from 30 labeled images (10 ME, 10 CSR, and 10 healthy), and SVM is trained on these. We applied our proposed algorithm on 90 time-domain OCT (TD-OCT) images (30 ME, 30 CSR, 30 healthy) of 73 patients. Our algorithm correctly classified 88 out of 90 subjects with accuracy, sensitivity, and specificity of 97.77%, 100%, and 93.33%, respectively.
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Tylus M, Święch-Zubilewicz A, Dolar-Szczasny J, Mackiewicz J. [Bilateral abnormalities in central serous chorioretinopathy seen in optical coherence tomography, ultra-widefield fluorescein angiography and microperimetry--case report]. Klin Oczna 2015; 117:173-176. [PMID: 26999941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Central serous chorioretinopathy is a common retinopathy, which is manifested by the idiopathic detachment of the neurosensory retina in the posterior pole, secondary to fluid leakage from choroidal vessels at the level of retinal pigment epithelium. The disease is typically unilateral and affects young men. We present a case of a 48-year old man, admitted to the Department of Vitreo-Retinal Surgery, Medical University in Lublin, reporting vision impairment in his right eye. The bilateral ocular exam followed by optical coherence tomography, ultra-widefield fluorescein angiography and microperimetry revealed bilateral central serous chorioretinopathy. This case presents a bilateral manifestation of central serous chorioretinopathy and emphasizes the role of advanced diagnostic imaging techniques in analyzing retinal function and disease management.
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Hamidi C, Türkcü FM, Göya C, Çetinçakmak MG, Yüksel H, Teke M, Hattapoğlu S, Bilici A. Evaluation of retrobulbar blood flow with color doppler ultrasonography in patients with central serous chorioretinopathy. J Clin Ultrasound 2014; 42:481-485. [PMID: 24752962 DOI: 10.1002/jcu.22156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 11/22/2013] [Accepted: 03/13/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND To compare retrobulbar blood flow in patients with central serous chorioretinopathy (CSC) and healthy subjects using color Doppler ultrasonography. METHODS Thirty patients (age 23-54 years) with a first episode of acute CSC and 30 healthy controls (age 30-44 years) were evaluated. The peak systolic blood flow velocity, end-diastolic velocity (EDV), resistance index (RI), and pulsatility index (PI) were measured in the ophthalmic, posterior ciliary, and central retinal arteries. RESULTS The posterior ciliary and central retinal artery EDV were lower in the patient group than in the control group, whereas RI and PI values were significantly higher (p < .05). The ophthalmic artery peak systolic blood flow velocity and EDV were lower in the CSC than in the control group (p < .05) without significant difference in RI and PI. CONCLUSIONS Color Doppler ultrasonography provides additional insights into the pathophysiology of CSC and may support the vasospasm hypothesis.
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Affiliation(s)
- Cihad Hamidi
- Department of Radiology, Medical School, Dicle University, Diyarbakir, Turkey
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Brandl C, Helbig H, Gamulescu MA. Choroidal thickness measurements during central serous chorioretinopathy treatment. Int Ophthalmol 2013; 34:7-13. [PMID: 23572440 DOI: 10.1007/s10792-013-9774-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 04/01/2013] [Indexed: 12/31/2022]
Abstract
To determine changes in choroidal thickness in patients with central serous chorioretinopathy (CSCR) during the first 3 months after initial diagnosis and assess variable therapeutic interventions via enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT). In this prospective study, choroidal thickness was measured via EDI-OCT both in the affected and fellow eyes of 10 patients with CSCR at the fovea, as well as at 500 and 1,000 μm both temporal and nasal from the centre of the fovea and at the leakage point (if present), visualised via fluorescein angiography. Follow-up measurements were performed after 2-3 weeks, 6-8 weeks and 3 months. Seven of the 10 patients received additional systemic therapy with oral acetazolamide. A control group of eight healthy subjects was recruited to determine normal choroidal thickness in healthy eyes. The mean age of the 10 patients (9 male, 1 female) in the CSCR group was 42.1 (±9.3) years. The choroid in the affected eyes was significantly thickened at baseline compared to fellow eyes and the eyes of healthy subjects. The choroid in the fellow eyes also revealed a slight thickening at baseline compared to normal eyes. During the 3 month follow-up period, the choroidal thickness of the affected eyes showed a highly significant decrease, but did not reach normal levels. Minor changes could also be observed in the fellow eyes but did not reach statistical significance. In patients with CSCR, the average choroidal thickness not only demonstrated a significant thickening at baseline, but also showed a marked decrease after 3 months, yet not reaching normal levels. Our data indicate that after 3 months, normalisation of choroidal thickness is not yet completed.
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Affiliation(s)
- Caroline Brandl
- Department of Ophthalmology, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany,
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Jamil AZ, Mirza KA, Qazi ZUA, Iqbal W, Khaliq J, Ahmed A. Features of central serous chorioretinopathy presenting at a tertiary care hospital in Lahore. J PAK MED ASSOC 2013; 63:478-482. [PMID: 23905445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To evaluate the clinical, angiographic and optical coherence tomographic features of central serous chorioretinopathy in patients presenting at a tertiary care centre in Lahore. METHODS The observational study was conducted at the Layton Rehmatulla Benevolent Trust Eye and Cancer Hospital Lahore from July 15, 2010 to December 15, 2011. Patients who had received prior treatment for the condition and allergy to fluorescein were excluded. There were 86 eyes of 64 adult patients with central serous chorioretinopathy. The following data was recorded: history, signs and symptoms, best corrected visual acuity, fundus fluorescein angiography, and central macular thickness measurement with optical coherence tomography. Data was analyzed using SPSS 17. RESULTS Mean age of patients who presented during the study duration was 39.52 +/- 8.85 years.There were 53 (82.8%) males and 11(17.2%) females. Of the total, 42 (65.6%) cases had unilateral and 22 (34.4%) cases had bilateral involvement. Chronic central serous chorioretinopathy was seen in 27 (42.2%) cases while 37 (57.8%) cases were acute presentations. Retinal pigment epithelial detachment was observed in 29 (45.3%) cases. On fundus fluorescein angiography, there were 62 (72.1%) eyes that showed ink blot pattern. Median visual acuity at presentation was 0.25. Median central macular thickness at presentation was 550.5micro. CONCLUSION Central serous chorioretinopathy in the study sample was associated with pigment epithelial detachment, bilateral involvement, and presence of systemic diseases.
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Li L, Li DH, Yang ZK, Bian AL, Chen YX, Dong FT. [Analysis of fundus fluorescein angiography, indocyanine green angiography and choroidal thickness in central serous chorioretinopathy]. Zhonghua Yan Ke Za Zhi 2012; 48:878-882. [PMID: 23302240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To evaluate the characteristics of choroidal thickness changes and abnormalities in choroidal circulation in cases of central serous chorioretinopathy (CSC). METHODS This was a case control study, we measured the bilateral choroidal thickness in 21 patients with unilateral CSC and 24 eyes of 24 age- and sex-matched normal subjects using enhanced depth imaging optical coherence tomography (EDI-OCT). The choroid was measured from the posterior edge of the retinal pigment epithelium (RPE) to the choroid-scleral junction at 500 µm intervals of a horizontal section from 3 mm temporal to the fovea to 3 mm nasal to the fovea. Paired-samples t-test was conducted to compare mean choroidal thicknesses between symptomatic eyes and fellow eyes of patients. The datum between patients and normal subjects were analyzed by independent-samples t-test. Fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed and the digital images were analyzed in CSC patients. RESULTS The 21 CSC patients had a mean age of 45.6 years, and 12 patients (57.1%) were male. The choroid in symptomatic eyes was thickest beneath the fovea (519.0 ± 102.5) µm. It was significantly thicker than that in the fellow eyes (439.3 ± 94.1) µm (t = 4.171, P < 0.05). Choroidal thickness in both groups was significantly greater than that in the eyes of age- and sex-matched normal subjects (332.0 ± 67.3) µm (t = 7.125, 4.441; P < 0.05). Choroidal thickness at each of the other 12 points showed a similar tendency (t = 2.544 to 3.819, 4.799 to 7.816, 2.487 to 5.236; P < 0.05). ICGA showed a choroidal filling delay (100%), vessels dilation (90.5%), and focal choroidal hyperfluorescence (100%) surrounding leakage from the RPE in symptomatic eyes. Pigment epithelium detachment with abnormal choroidal circulation was observed in 6 fellow eyes. In 4 symptomatic eyes and 11 fellow eyes, ICGA revealed choroidal hyperfluorescence but FFA showed normal appearance. CONCLUSIONS CSC seems to be a bilateral eye disease with choroidal focal ischemia followed by vessels congestion and hyperpermeability. EDI OCT is a useful tool for monitoring choroidal thickness changes caused by choroidal vascular hyperpermeability.
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Affiliation(s)
- Lüe Li
- Department of Ophthalmology, Chinese Academy of Medical Sciences, Beijing, China
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Yang LH, Tian B, Shi XH, Ding N, Zhou D, Wei WB. [Changes of choroidal thickness in central serous chorioretinopathy]. Zhonghua Yan Ke Za Zhi 2012; 48:874-877. [PMID: 23302239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To determine the quantitative changes of choroidal thickness in central serous chorioretinopathy. METHODS Cross-sectional study. Twenty-three patients with unilateral central serous chorioretinopathy (CSC) in acute and chronic stages were diagnosed after fluorescein angiography, indocyanine angiography and enhanced depth imaging optical coherence tomography (EDI OCT). EDI OCT scan across the fovea was performed in each eye and the result was compared with that from an age-, sex-matched and spherical equivalent-matched control subject. Subfoveal thickness of choroid was calculated by a onboard software in HRA2. RESULTS Choroidal thickness in the CSC eyes and the fellow eyes was (464.43 ± 97.15) µm and (399.91 ± 124.01) µm, respectively. No significant difference between the two groups (t = 4.653, P < 0.05). Choroidal thickness was (313.09 ± 70.67) µm in the control group. There was statistically significant difference in thickness between the CSC group and the control group (t = 5.077, -2.085; P < 0.05). Choroidal thickness in the fellow eyes with choroidal vascular hyperpermeability was (506.44 ± 75.66) µm, which was differed significantly (t = 4.749, P < 0.05)from the non-hypermeability eyes (331.43 ± 97.94) µm. CONCLUSIONS Subfoveal choroid thickness in the symptomatic eye and the fellow eyes in CSC group is thicker than that of the control group. The subfoveal choroidal thickness of eyes with hypermeability is thicker than that in the non-hypermeability eyes. EDI-OCT is a noninvasive procedure which can be used to evaluate the choroidal hypermeability in CSC.
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Affiliation(s)
- Li-hong Yang
- Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing, China
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Chen GF, Ma JX, Zhang TD, Wang CL, Li SF, Yang AQ. [The analysis of fundus fluorescein angiography, indocyanine green angiography and hemodynamics of retrobulbar blood vessels in central serous chorioretinopathy]. Zhonghua Yan Ke Za Zhi 2009; 45:243-247. [PMID: 19575920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To analyze the characteristics of the retrobulbar blood vessels' hemodynamics changes and the choroidal circulation disorder, and to observe the relations between retinal pigment epithelium's (RPE) pathological changes and them. METHODS It was a case control study. For 57 (57 affected eyes and 57 contralateral eyes) unilateral eye affected patients and 25 (50 eyes) normal health adults, we examined ophthalmic arteries (OA), posterior ciliary arteries (PCA) and short posterior ciliary arteries (SPCA) by color Doppler flow Imaging (CDFI), and recorded the peak systolic velocities (PSV), end diastolic velocities (EDV) and resistance indexes (RI) of them. We compared each hemodynamic parameter of the normal eyes with it of the affected eyes and contralateral eyes in patients group respectively, and contrasted them between affected eyes and contralateral eyes of the patients. Fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed simultaneously on 57 patients with Heidelberg retina angiography, and the images were analyzed in contrast. We used SPSS 12.0 statistics software was used in the study. To the PSV, EDV and RI of the OA, PCA and SPCA in affected eyes and contralateral eyes of the patients, we used paired t-test for the same sample to compare their hemodynamic parameters; to compare normal health adults' eyes with the affected eyes and the contralateral eyes of patients group respectively, we used two-group t-test. When the P-value was less than 0.05, there was a statistical significance. RESULTS There was a more significant decrease of the hemodynamic parameters in both PSVs and EDVs of temporal PCAs (PSV: t = 3.044, P = 0.005; EDV: t = 3.731, P = 0.001) and temporal SPCAs (PSV: t = 2.822, P = 0.008; EDV: t = 3.194, P = 0.003) compared the patients group's affected eyes with normal health adults group eyes, there was a more significant decrease of them of temporal PCAs (PSV: t = 3.219, P = 0.003; EDV: t = 3.807, P = 0.001) and temporal SPCAs (PSV: t = 3.931, P = 0.000, EDV: t = 3.145, P = 0.003) compared the patients group's contralateral eyes with normal health adults group eyes, and there was a statistical significance of them (P < 0.05). There was no difference in hemodynamic parameters of both PSVs and EDVs of temporal PCAs (PSV: t = 0.608, P = 0.548; EDV: t = 0.122, P = 0.904) and temporal SPCAs (PSV: t = 0.730, P = 0.470; EDV: t = 0.109, P = 0.914) between affected eyes and contralateral eyes of the patients, and there was no statistical significance of them (P > 0.05). The results of FFA and ICGA showed that all the RPE's leaks of 57 affected eyes appeared at the hypofluorescent regions of relative choroids; 52 cases of 57 affected eyes were followed by choroidal vessels dilatation at the early hypofluorescent regions, and appeared hyperfluorescence leakages in the late phase images; At the all regions of RPE's transmitted fluorescences of affected eyes and contralateral eyes, the corresponding choroids showed hyperfluorescence in the late phase images in ICGA; There were no RPE's transmitted fluorescences at the regions of 20 affected eyes and 16 contralateral eyes in FFA, which showed hyperfluoresceince leakages in the late phase images of choroids in ICGA. CONCLUSIONS CSC is possibly a bilateral disease associated with systemic pathologic conditions. Hypoperfusion and ischemia are the basal characteristics of retrobulbar blood vessels' circulation disorder and choroidal ultracirculation disorder. The damage of RPE is following to the choroidal circulation disorder.
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Affiliation(s)
- Gui-fen Chen
- Second Hospital of Hebei Medical University, Shijiazhuang 050000, China.
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