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Jesse J Jung, Quan V Hoang, Soraya Rofagha, David Sarraf, K Bailey Freund; Ultra-widefield Indocyanine Green Angiography in Central Serous Chorioretinopathy and Pachychoroid Pigment Epitheliopathy. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5353. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To demonstrate the role of ultra-widefield indocyanine green angiography (UWICGA) in identifying choroidal pathology in both central serous chorioretinopathy (CSC) and pachychoroid pigment epitheliopathy (PPE).
This prospective, cohort study evaluated 15 eyes (8 patients) with a diagnosis of CSC or PPE who were imaged with multimodal imaging including UWICGA (Optos, Marlborough, MA, USA). Detailed analyses of the patterns of UWICGA imaging were correlated with the findings of clinical history and examination and enhanced depth/spectral-domain optical coherence tomography. For continuous variables, an independent 2-tailed t-test was performed. Statistical significance was defined as p<0.05.
Fifteen eyes (10 CSC, 5 PPE) of 8 patients (all male) were evaluated. Within the CSC cohort, the age was 47.6 +/-6.6 (mean +/- standard deviation) and in the PPE cohort was 43.3 +/-6.9 (p=0.22). Five patients were White, 2 Asian and 1 Hispanic. Two patients had a history of steroid use. Four had acute symptoms (<6 months) and 4 had chronic symptoms (≥6 months). Two eyes had a history of recurrent CSC with 2 prior episodes that did not require treatment. Mean best-corrected visual acuity in the CSC eyes was 20/34 (range: 20/20-20/126) and in the PPE eyes, was 20/20 (range 20/20-20/25, p=0.12). Mean central foveal thickness in the CSC eyes was 312.3 +/-109.4 and in PPE eyes was 271.0 +/-23.3 (p=0.43). Mean subfoveal choroidal thickness (SFCT) was 566.3 +/-60.1 in CSC eyes and 511.6 +/-45.0 (p=0.098) in PPE eyes. Eight out of 10 eyes (80%) had subretinal fluid (SRF) in the CSC eyes and 0/5 (0%) had SRF in the PPE eyes. All 10 CSC eyes had posterior hyperautofluorescence with 4 having a focal pattern, 4 with a guttering pattern and 2 having a diffuse pattern. All CSC and PPE eyes demonstrated early dilated choroidal vessels and late hyperpermeability on UWICGA. Nine of 10 (90%) CSC eyes had all 4 vortex veins dilated whereas 1 eye had 3 dilated vortex veins. Four of 5 (80%) PPE eyes had all 4 vortex veins dilated whereas 1 eye had 3 dilated vortex veins.
Multimodal imaging including UWICGA enables visualization of choroidal hyperpermeability in CSC and PPE. Choroidal congestion and dilated vortex veins correspond to increased SFCT in CSC and PPE suggesting that these entities share a common choroidal vascular abnormality.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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