Abstract
Purpose
To evaluate the three-dimensional choroidal vascularity index (CVI) in the eyes with treatment-naïve acute central serous chorioretinopathy (CSC) using swept-source optical coherence tomography (SS OCT).
Methods
In this prospective cross-sectional study, OCT and OCT angiography covered an area of 12 × 12 mm centered on the fovea. Three-dimensional CVI was defined as the ratio of the choroidal vascular luminal volume to the total choroidal volume. The location of pigment epithelial detachment (PED) and the area with abnormal perfusion at choriocapillary layer were compared with the distribution of the three-dimensional CVI.
Results
Thirty-two eyes with treatment-naïve acute CSC, 18 fellow eyes, and 48 control eyes were enrolled. Three-dimensional CVI had good repeatability on control eyes, with a coefficient of variation of 0.166. The mean CVI in the scan area was 0.35 in the eyes with CSC, 0.34 in the fellow eyes of CSC, and 0.30 in the control eyes. The overall CVI in the control eyes was significantly lower than that in the eyes with CSC and that in fellow eyes (P < 0.001 and P = 0.006, respectively). The eyes with CSC and the fellow eyes had significantly higher CVI values at the posterior pole and the drainage routes of choroidal veins. In the eyes with CSC, PEDs and choriocapillary with abnormal perfusion colocalized with the dilated choroidal vessels, which had high three-dimensional CVI values.
Conclusion
Increased three-dimensional CVI suggested an increased vascular component in the eyes with CSC and in fellow eyes. The three-dimensional CVI is a useful imaging marker of choroidal diseases that volumetrically assesses the choroidal vasculature and might advance our understanding of CSC pathophysiology.
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References
Daruich A, Matet A, Dirani A, Bousquet E, Zhao M, Farman N, Jaisser F, Behar-Cohen F (2015) Central serous chorioretinopathy: recent findings and new physiopathology hypothesis. Prog Retin Eye Res 48:82–118. https://doi.org/10.1016/j.preteyeres.2015.05.003
Dansingani KK, Balaratnasingam C, Naysan J, Freund KB (2016) En face imaging of pachychoroid spectrum disorders with swept-source optical coherence tomography. Retina 36:499–516. https://doi.org/10.1097/iae.0000000000000742
Agrawal R, Chhablani J, Tan KA, Shah S, Sarvaiya C, Banker A (2016) Choroidal vascularity index in central serous chorioretinopathy. Retina 36:1646–1651. https://doi.org/10.1097/iae.0000000000001040
Lane M, Moult EM, Novais EA, Louzada RN, Cole ED, Lee B, Husvogt L, Keane PA, Denniston AK, Witkin AJ, Baumal CR, Fujimoto JG, Duker JS, Waheed NK (2016) Visualizing the choriocapillaris under drusen: comparing 1050-nm swept-source versus 840-nm spectral-domain optical coherence tomography angiography. Invest Ophthalmol Vis Sci 57:Oct585–Oct590. https://doi.org/10.1167/iovs.15-18915
Copete S, Flores-Moreno I, Montero JA, Duker JS, Ruiz-Moreno JM (2014) Direct comparison of spectral-domain and swept-source OCT in the measurement of choroidal thickness in normal eyes. Br J Ophthalmol 98:334–338. https://doi.org/10.1136/bjophthalmol-2013-303904
Liegl R, Ulbig MW (2014) Central serous chorioretinopathy. Ophthalmologica 232:65–76. https://doi.org/10.1159/000360014
Daruich A, Matet A, Behar-Cohen F (2017) Central serous chorioretinopathy. Dev Ophthalmol 58:27–38. https://doi.org/10.1159/000455267
Agrawal R, Gupta P, Tan KA, Cheung CM, Wong TY, Cheng CY (2016) Choroidal vascularity index as a measure of vascular status of the choroid: measurements in healthy eyes from a population-based study. Sci Rep 6:21090. https://doi.org/10.1038/srep21090
Rasheed MA, Goud A, Mohamed A, Vupparaboina KK, Chhablani J (2018) Change in choroidal vascularity in acute central serous chorioretinopathy. Indian J Ophthalmol 66:530–534. https://doi.org/10.4103/ijo.IJO_1160_17
Ambiya V, Goud A, Rasheed MA, Gangakhedkar S, Vupparaboina KK, Chhablani J (2018) Retinal and choroidal changes in steroid-associated central serous chorioretinopathy. Int J Retina Vitreous 4:11. https://doi.org/10.1186/s40942-018-0115-1
Agrawal R, Wei X, Goud A, Vupparaboina KK, Jana S, Chhablani J (2017) Influence of scanning area on choroidal vascularity index measurement using optical coherence tomography. Acta Ophthalmol 95:e770–e775. https://doi.org/10.1111/aos.13442
Chinn SR, Swanson EA, Fujimoto JG (1997) Optical coherence tomography using a frequency-tunable optical source. Opt Lett 22:340–342
Kogure K, David NJ, Yamanouchi U, Choromokos E (1970) Infrared absorption angiography of the fundus circulation. Arch Ophthalmol 83:209–214
van Velthoven ME, Verbraak FD, Garcia PM, Schlingemann RO, Rosen RB, de Smet MD (2005) Evaluation of central serous retinopathy with en face optical coherence tomography. Br J Ophthalmol 89:1483–1488. https://doi.org/10.1136/bjo.2005.073056
Cheung CMG, Lai TYY, Ruamviboonsuk P, Chen SJ, Chen Y, Freund KB, Gomi F, Koh AH, Lee WK, Wong TY (2018) Polypoidal choroidal vasculopathy: definition, pathogenesis, diagnosis, and management. Ophthalmology 125:708–724. https://doi.org/10.1016/j.ophtha.2017.11.019
Chen FK, Viljoen RD, Bukowska DM (2016) Classification of image artefacts in optical coherence tomography angiography of the choroid in macular diseases. Clin Exp Ophthalmol 44:388–399. https://doi.org/10.1111/ceo.12683
Singh SR, Invernizzi A, Rasheed MA, Cagini C, Goud A, Vupparaboina KK, Cozzi M, Lupidi M, Chhablani J (2018) Wide-field choroidal vascularity in healthy eyes. Am J Ophthalmol 193:100–105. https://doi.org/10.1016/j.ajo.2018.06.016
Hirami Y, Tsujikawa A, Sasahara M, Gotoh N, Tamura H, Otani A, Mandai M, Yoshimura N (2007) Alterations of retinal pigment epithelium in central serous chorioretinopathy. Clin Exp Ophthalmol 35:225–230. https://doi.org/10.1111/j.1442-9071.2006.01447.x
Yang L, Jonas JB, Wei W (2013) Optical coherence tomography-assisted enhanced depth imaging of central serous chorioretinopathy. Invest Ophthalmol Vis Sci 54:4659–4665. https://doi.org/10.1167/iovs.12-10991
Hiroe T, Kishi S (2018) Dilatation of asymmetric vortex vein in central serous chorioretinopathy. Ophthalmol Retina 2:152–161. https://doi.org/10.1016/j.oret.2017.05.013
Zhou H, Chu Z, Zhang Q, Dai Y, Gregori G, Rosenfeld PJ, Wang RK (2018) Attenuation correction assisted automatic segmentation for assessing choroidal thickness and vasculature with swept-source OCT. Biomed Opt Express 9:6067–6080. https://doi.org/10.1364/boe.9.006067
Qu Y, Gong D, Yu W, Dong F (2017) Characteristics of the choriocapillaris layer in optical coherence tomography angiography of acute central serous chorioretinopathy. Ophthalmic Surg Lasers Imaging Retina 48:1000–1005. https://doi.org/10.3928/23258160-20171130-07
De Bats F, Cornut PL, Wolff B, Kodjikian L, Mauget-Faysse M (2018) Dark and white lesions observed in central serous chorioretinopathy on optical coherence tomography angiography. Eur J Ophthalmol 28:446–453. https://doi.org/10.1177/1120672118758401
Nicolo M, Rosa R, Musetti D, Musolino M, Saccheggiani M, Traverso CE (2017) Choroidal vascular flow area in central serous chorioretinopathy using swept-source optical coherence tomography angiography. Invest Ophthalmol Vis Sci 58:2002–2010. https://doi.org/10.1167/iovs.17-21417
Acknowledgments
Thanks are due to Cheng Yan, Hongxia Chang, Jiayin Wang, and Shan Wu for collecting data and supporting this study.
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Supplementary Fig.
Coefficient of variation of the choroidal vascularity index (CVI) in 12 × 12 mm girds in control eyes and fellow eyes of central serous chorioretinopathy. The left halves of these tables had relatively less CVI values. (PNG 1142 kb)
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Yang, J., Wang, E., Yuan, M. et al. Three-dimensional choroidal vascularity index in acute central serous chorioretinopathy using swept-source optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 258, 241–247 (2020). https://doi.org/10.1007/s00417-019-04524-7
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DOI: https://doi.org/10.1007/s00417-019-04524-7