Choroidal Vascular Features in Central Serous Chorioretinopathy: Widefield Multimodal Analysis

Authors

  • Pedro Carreira Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal; Universidade do Algarve, Faro, Portugal https://orcid.org/0000-0003-3376-7040
  • Prithvi Ramtohul Vitreous, Retina, Macula Consultants of New York, NY, United States of America
  • Audrey Sampaio Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal; Universidade do Algarve, Faro, Portugal
  • Ana Rita Carreira Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal; Universidade do Algarve, Faro, Portugal
  • Ana Mafalda Pereira Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal; Universidade do Algarve, Faro, Portugal
  • Rita Laiginhas Centro Hospital Universitário de São João, Porto, Portugal
  • Nuno Campos Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal; Universidade do Algarve, Faro, Portugal
  • Diogo Cabral Centro de Responsabilidade Integrada de Oftalmologia, Hospital Garcia de Orta, Almada, Portugal; Universidade do Algarve, Faro, Portugal; iNOVA4Health, NOVA Medical School I Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisboa, Portugal https://orcid.org/0000-0003-3376-7040

DOI:

https://doi.org/10.48560/rspo.28617

Keywords:

Angiography, Central Serous Chorioretinopathy, Indocyanine Green, Tomography, Optical Coherence

Abstract

INTRODUCTION: Our objective was to evaluate choroidal vascular features of patients with central serous chorioretinopathy (CSC) using widefield (WF) swept-source optical coherence tomography (SS-OCT) and ultra-widefield (UWF) indocyanine green angiography (ICGA).
METHODS: Observational study with a prospective design conducted in patients with CSC. All cases underwent UWF ICGA using a confocal scanning laser ophthalmoscopy (SLO) device and WF SS-OCT. WF en face OCT images of the choroid and mid-late UWF ICGA images were created using Photoshop. The image analysis protocol comprised the analysis of choroidal vascular features in UWF ICGA (symmetric vortex veins territories; pachyvessels crossing watershed territories; choroidal vascular hyperpermeability (CVH) and intervortex anastomosis) and WF en face SS-OCT images (pachyvessels crossing watershed areas and intervortex anastomoses). Cor- relation between the variables of interest was performed using the Pearson correlation coefficient. Statistical significance was set as <0.05.
RESULTS: A total of 23 eyes from 12 patients diagnosed with CSC were included in the analysis. Symmetry analysis in UWF ICGA showed asymmetric vortex vein territories in 16 eyes (70%). The most prevalent asymmetric territory was the inferior-nasal (10 eyes, 43%). Pachyvessels crossing choroidal watershed zones were present in 20 of eyes (87%) with a perfect agreement between UWF ICGA and en face UWF OCT (r = 1.0). Both horizontal and vertical watershed areas were crossed in 8 eyes (40%). Evaluation of intervortex anastomosis showed a higher prevalence when evaluated by en face WF OCT (26%, 6 eyes). A moderate correlation between asymmetric vortex vein territories and intervortex anastomoses was observed (r = 0.51). Mid-late CVH in ICGA was present in 19 cases (83%), among which 5 cases (26%) showed diffuse CVH. A moderate positive correlation (r = 0.53) was also observed between diffuse CVH and pachyvessels crossing both meridians.
CONCLUSION: WF en face SS-OCT can be used to detect non-invasively choroidal vascular anomalies in CSC. Pachyvessels crossing the horizontal and vertical meridians are moderately associated with diffuse CVH in ICGA, supporting its role as a non-invasive biomarker of choroidal venous insufficiency.

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Published

2024-03-24

How to Cite

Carreira, P., Ramtohul, P., Sampaio, A., Carreira, A. R., Pereira, A. M., Laiginhas, R., Campos, N., & Cabral, D. (2024). Choroidal Vascular Features in Central Serous Chorioretinopathy: Widefield Multimodal Analysis. Revista Sociedade Portuguesa De Oftalmologia, 48(1), 16–22. https://doi.org/10.48560/rspo.28617

Issue

Vol. 48 No. 1 (2024)

Section

Original Article

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