Choroidal Neovascularisation Complicating Chronic Central Serous Chorioretinopathy: The Discovery Rate on Multimodal Imaging

Abstract

Purpose To identify the image modality allowing identification of choroidal neovascularisation (CNV) complicating chronic central serous chorioretinopathy (CSCR), including fluorescein angiography (FA), indocyanine green angiography (ICGA), and optical coherence tomography angiography (OCT-A).

Methods Patients diagnosed with chronic CSCR and secondary CNV were included in the study. The image modalities FA, ICGA, and OCT-A were reviewed for specific CNV signs permitting diagnosis. Patients with missing image modalities, poor image quality, previous laser treatment, or other confounding pathologies were excluded.

Results CNV was identified on OCT-A in 32 of 33 eyes (97%), whereas ICGA revealed an abnormal vascular network in 23 eyes (70%), significantly less frequently than with OCT-A (p = 0.003). FA allowed CNV identification in 10 eyes (30%), significantly less frequently than with OCT-A (p < 0.001). Type 1 CNV was detected by OCT-A in 29 of 30 eyes (97%), by ICGA in 20 eyes (67%; p = 0.0027), and by FA in 8 eyes (27%; p < 0.001).

Conclusions OCTA is a useful diagnostic tool to detect occult CNV complicating chronic CSCR. This image modality might be important for adequate patient care.

Zusammenfassung

Hintergrund Die Studie beabsichtigt, die Bildgebungsmethoden hinsichtlich der Identifikation neovaskulärer Membranen bei zentraler seröser Chorioretinopathie zu untersuchen.

Methode Patienten mit chronischer zentraler seröser Chorioretinopathie und sekundärer choroidaler Neovaskularisationsmembran und Bildgebung mit Fluoresceinangiografie (FA), Indocyaningrünangiografie (ICGA) und optischer Kohärenztomografieangiografie (OCT-A) wurden eingeschlossen. Ausgeschlossen waren schlechte Bildqualität, Status nach Laser und andere Netzhauterkrankungen.

Ergebnisse Eine Neovaskularisationsmembran war mittels OCT-A in 32 von 33 Augen (97%) identifizierbar, während die ICGA das abnormale vaskuläre Netzwerk in 23 Augen (70%) zeigte. Die FA jedoch konnte die Membranen nur in 10 Augen (30%) nachweisen, signifikant weniger häufig als die OCT-A (p < 0,001). Es handelte sich bei den Neovaskularisationsmembranen mehrheitlich um den Typ 1 (30 Augen von 33) und unter diesen war die Identifikationsrate bei 97% in der OCT-A, 67% in der ICGA und 27% in der FA.

Schlussfolgerungen Die OCT-A ist eine sehr nützliche Bildgebungsmethode, um die meist okkulten choroidalen Neovaskularisationsmembranen bei chronischer zentraler seröser Chorioretinopathie zu entdecken. Insofern dürfte die OCT-A eine wichtige Rolle spielen, um die Patienten richtig zu behandeln.

Key words

central serous chorioretinopathy - choroidal neovascularisation - optical coherence tomography angiography

Schlüsselwörter

zentrale seröse Chorioretinopathie - choroidale Neovaskularisation - optische Kohärenztomografieangiografie

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