Abstract
Purpose
To correlate function and structural optical coherence tomography (OCT) to optical coherence tomography angiography (OCT-A) measures in patients affected by central serous chorioretinopathy (CSC) and to describe their changes after treatments (ie oral eplerenone, half-fluence photodynamic therapy (PDT)).
Patients and methods
Twenty eyes of 16 consecutive patients with treatment-naïve CSC undergoing either eplerenone or PDT were enrolled in this prospective, observational study. All patients underwent structural OCT and OCT-A at baseline and after therapy at months 1 and 3.
Results
Eleven eyes of nine patients and nine eyes of seven patients underwent eplerenone or PDT treatment, respectively. Central macular thickness (CMT) and subretinal fluid (SRF) correlated to fovea avascular zone (FAZ) area (r=0.74 and r=0.71, P=0.01) and vessel density (r=0.77 and r=0.68, P=0.01) at deep capillary plexus (DCP). CMT (P=0.0011), SRF (P=0.0005), SFCT (P=0.0016), FAZ area at DCP (P=0.0334) improved at 3-month visit. A significant reduction of deep FAZ area was appreciated in eplerenone (P=0.0204) but not in PDT (P=0.5) group. SFCT reduction was significantly higher in PDT than eplerenone group (P=0.0347).
Conclusion
Structural and vascular parameters are correlated in CSC and they improve after different treatments. Both half-fluence PDT and oral eplerenone do not permanently damage choriocapillaris or other choroidal layers as evaluated by OCT-A.
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References
Kitzmann AS, Pulido JS, Diehl NN, Hodge DO, Burke JP . The incidence of central serous chorioretinopathy in Olmsted County, Minnesota, 1980–2002. Ophthalmology 2008; 115 (1): 169–173.
Wang M, Munch IC, Hasler PW, Prunte C, Larsen M . Central serous chorioretinopathy. Acta Ophthalmol 2008; 86 (2): 126–145.
Daruich A, Matet A, Dirani A, Bousquet E, Zhao M, Farman N et al. Central serous chorioretinopathy: recent findings and new physiopathology hypothesis. Prog Retin Eye Res 2015; 48: 82–118.
Rabiolo A, Carnevali A, Bandello F, Querques G . Optical coherence tomography angiography: evolution or revolution? Exp Rev Ophthalmol 2016; 11 (4): 243–245.
Bonini Filho MA, de Carlo TE, Ferrara D, Adhi M, Baumal CR, Witkin AJ et al. Association of choroidal neovascularization and central serous chorioretinopathy with optical coherence tomography angiography. JAMA Ophthalmol 2015; 133 (8): 899–906.
Costanzo E, Cohen SY, Miere A, Querques G, Capuano V, Semoun O et al. Optical coherence tomography angiography in central serous chorioretinopathy. J Ophthalmol 2015; 2015: 134783.
Quaranta-El Maftouhi M, El Maftouhi A, Eandi CM . Chronic central serous chorioretinopathy imaged by optical coherence tomographic angiography. Am J Ophthalmol 2015; 160 (3): 581–587 e581.
Teussink MM, Breukink MB, van Grinsven MJ, Hoyng CB, Klevering BJ, Boon CJ et al. OCT angiography compared to fluorescein and indocyanine green angiography in chronic central serous chorioretinopathy. Invest Ophthalmol Vis Sci 2015; 56 (9): 5229–5237.
Kuroda Y, Ooto S, Yamashiro K, Oishi A, Nakanishi H, Tamura H et al. Increased choroidal vascularity in central serous chorioretinopathy quantified using swept-source optical coherence tomography. Am J Ophthalmol 2016; 169: 199–207.
Casalino G, Del Turco C, Corvi F, Rafaeli O, Bandello F, Querques G . Short-term retinal sensitivity and metamorphopsia changes following half-fluence photodynamic therapy in central serous chorioretinopathy. Ophthalmic Res 2016; 56 (1): 23–29.
Samara WA, Say EA, Khoo CT, Higgins TP, Magrath G, Ferenczy S et al. Correlation of foveal avascular zone size with foveal morphology in normal eyes using optical coherence tomography angiography. Retina 2015; 35 (11): 2188–2195.
Shahlaee A, Pefkianaki M, Hsu J, Ho AC . Measurement of foveal avascular zone dimensions and its reliability in healthy eyes using optical coherence tomography angiography. Am J Ophthalmol 2016; 161: 50–55 e51.
Battaglia Parodi M, Cicinelli MV, Rabiolo A, Pierro L, Bolognesi G, Bandello F . Vascular abnormalities in patients with Stargardt disease assessed with optical coherence tomography angiography. Br J Ophthalmol 2016; 101 (6): 780–785.
Chidambara L, Gadde SG, Yadav NK, Jayadev C, Bhanushali D, Appaji AM et al. Characteristics and quantification of vascular changes in macular telangiectasia type 2 on optical coherence tomography angiography. Br J Ophthalmol 2016; 100 (11): 1482–1488.
Goktas A . Correlation of subretinal fluid volume with choroidal thickness and macular volume in acute central serous chorioretinopathy. Eye (Lond) 2014; 28 (12): 1431–1436.
Maruko I, Iida T, Sugano Y, Ojima A, Sekiryu T . Subfoveal choroidal thickness in fellow eyes of patients with central serous chorioretinopathy. Retina 2011; 31 (8): 1603–1608.
Lee WJ, Lee JH, Lee BR . Fundus autofluorescence imaging patterns in central serous chorioretinopathy according to chronicity. Eye (Lond) 2016; 30 (10): 1336–1342.
Hayashi K, Hasegawa Y, Tokoro T . Indocyanine green angiography of central serous chorioretinopathy. Int Ophthalmol 1986; 9 (1): 37–41.
Menchini U, Virgili G, Lanzetta P, Ferrari E . Indocyanine green angiography in central serous chorioretinopathy. ICG angiography in CSC. Int Ophthalmol 1997; 21 (2): 57–69.
Tsujikawa A, Ojima Y, Yamashiro K, Ooto S, Tamura H, Nakagawa S et al. Punctate hyperfluorescent spots associated with central serous chorioretinopathy as seen on indocyanine green angiography. Retina 2010; 30 (5): 801–809.
Yannuzzi LA . Indocyanine green angiography: a perspective on use in the clinical setting. Am J Ophthalmol 2011; 151 (5): 745–751 e741.
Tomasso L, Benatti L, Rabiolo A, Carnevali A, Zucchiatti I, Querques L et al. Retinal vessels functionality in eyes with central serous chorioretinopathy. Br J Ophthalmol 2017; e-pub ahead of print 9 June 2017; doi: 10.1136/bjophthalmol-2017-310398.
Cicinelli MV, Carnevali A, Rabiolo A, Querques L, Zucchiatti I, Scorcia V et al. Clinical spectrum of macular-foveal capillaries evaluated with optical coherence tomography angiography. Retina 2017; 37 (3): 436–443.
La Spina C, Carnevali A, Marchese A, Querques G, Bandello F . Reproducibility and reliability of optical coherence tomography angiography for foveal avascular zone evaluation and measurement in different settings. Retina 2016; 37 (9): 1636–1641.
Yanik Odabas O, Demirel S, Ozmert E, Batioglu F . Repeatability of automated vessel density and superficial and deep foveal avascular zone area measurements using optical coherence tomography angiography: diurnal findings. Retina 2017; e-pub ahead of print 2 May 2017; doi: 10.1097/IAE.0000000000001671.
Venugopal JP, Rao HL, Weinreb RN, Pradhan ZS, Dasari S, Riyazuddin M et al. Repeatability of vessel density measurements of optical coherence tomography angiography in normal and glaucoma eyes. Br J Ophthalmol 2017; e-pub ahead of print 24 July 2017; doi: 10.1136/bjophthalmol-2017-310637.
Yalcinbayir O, Gelisken O, Akova-Budak B, Ozkaya G, Gorkem Cevik S, Yucel AA . Correlation of spectral domain optical coherence tomography findings and visual acuity in central serous chorioretinopathy. Retina 2014; 34 (4): 705–712.
Salehi M, Wenick AS, Law H, Evans JR, Gehlbach P . Interventions for central serous chorioretinopathy: a network meta-analysis. Cochrane Database Syst Rev 2015; (12): CD011841.
Mehta PH, Meyerle C, Sivaprasad S, Boon C, Chhablani J . Preferred practice pattern in central serous chorioretinopathy. Br J Ophthalmol 2016; 101 (5): 587–590.
Chan WM, Lam DS, Lai TY, Tam BS, Liu DT, Chan CK . Choroidal vascular remodelling in central serous chorioretinopathy after indocyanine green guided photodynamic therapy with verteporfin: a novel treatment at the primary disease level. Br J Ophthalmol 2003; 87 (12): 1453–1458.
Lim JI, Glassman AR, Aiello LP, Chakravarthy U, Flaxel CJ, Spaide RF et al. Collaborative retrospective macula society study of photodynamic therapy for chronic central serous chorioretinopathy. Ophthalmology 2014; 121 (5): 1073–1078.
Reibaldi M, Cardascia N, Longo A, Furino C, Avitabile T, Faro S et al. Standard-fluence versus low-fluence photodynamic therapy in chronic central serous chorioretinopathy: a nonrandomized clinical trial. Am J Ophthalmol 2010; 149 (2): 307–315 e302.
Ma J, Meng N, Xu X, Zhou F, Qu Y . System review and meta-analysis on photodynamic therapy in central serous chorioretinopathy. Acta Ophthalmol 2014; 92 (8): e594–e601.
Zhao M, Celerier I, Bousquet E, Jeanny JC, Jonet L, Savoldelli M et al. Mineralocorticoid receptor is involved in rat and human ocular chorioretinopathy. J Clin Invest 2012; 122 (7): 2672–2679.
Delyani JA . Mineralocorticoid receptor antagonists: the evolution of utility and pharmacology. Kidney Int 2000; 57 (4): 1408–1411.
Chung YR, Kim JW, Kim SW, Lee K . Choroidal thickness in patients with central serous chorioretinopathy: assessment of Haller and Sattler layers. Retina 2016; 36 (9): 1652–1657.
Maruko I, Iida T, Sugano Y, Ojima A, Ogasawara M, Spaide RF . Subfoveal choroidal thickness after treatment of central serous chorioretinopathy. Ophthalmology 2010; 117 (9): 1792–1799.
Gergely R, Kovacs I, Schneider M, Resch M, Papp A, Recsan Z et al. Mineralocorticoid receptor antagonist treatment in bilateral chronic central serous chorioretinopathy: a comparative study of exudative and nonexudative fellow eyes. Retina 2016; 37 (6): 1084–1091.
Oh BL, Yu HG . Choroidal thickness after full-fluence and half-fluence photodynamic therapy in chronic central serous chorioretinopathy. Retina 2015; 35 (8): 1555–1560.
Kinoshita T, Mitamura Y, Mori T, Akaiwa K, Semba K, Egawa M et al. Changes in choroidal structures in eyes with chronic central serous chorioretinopathy after half-dose photodynamic therapy. PLoS One 2016; 11 (9): e0163104.
Schmidt-Erfurth U, Laqua H, Schlotzer-Schrehard U, Viestenz A, Naumann GO . Histopathological changes following photodynamic therapy in human eyes. Arch Ophthalmol 2002; 120 (6): 835–844.
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Rabiolo, A., Zucchiatti, I., Marchese, A. et al. Multimodal retinal imaging in central serous chorioretinopathy treated with oral eplerenone or photodynamic therapy. Eye 32, 55–66 (2018). https://doi.org/10.1038/eye.2017.290
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DOI: https://doi.org/10.1038/eye.2017.290
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