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Elodie Bousquet, Valerie Krivosic, Ramin Tadayoni, Alain Gaudric; Optical Coherence Tomography angiography of Flat Irregular Pigment Epithelium Detachment in Central Serous Chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5480. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Retinal pigment epithelium detachments (PED) are found in most of the cases of central serous chorioretinopathy (CSCR) with variable aspects. A “dome-shaped” PED is present in acute CSCR and “flat irregular” PED is more likely observed in chronic CSCR. Type 1 choroidal neovascularization (CNV) may complicate chronic CSCR and the distinction between both entities can be complex because of overlapping imaging features.This study evaluates the rate of CNV in eyes with “flat irregular” PED using optical coherence tomography angiography (OCT-A).
Retrospective observational case series study of patients with CSCR. Multimodal imaging including OCT, indocyanine green (ICG-A)/fluorescein angiography (FA) and OCT-A (Avanti RTVue, Optovue, California, USA) were reviewed. Macular cubes (3X3mm and 6X6mm) centered on the fovea were analyzed by two masked graders for the detection of choroidal neovascularisation and flat irregular PED, which was defined as an irregular elevation of RPE allowing the visualization of Bruch's membrane.
Eighty seven eyes of 59 patients with CSCR were included. Patients’ mean age was 52 years (range, 30-84). Forty six patients (78%) were male. Flat irregular PED were present in 55 eyes (63.2%). OCT-A allowed the detection of CNV in 11 eyes (20%) with flat irregular PED. CNV were not associated with retinal hemorrhage or hard exsudates. They did not display a neovascular network on FA nor ICG-A. This proportion is very close from the rate found in a previous study evaluating the presence of CNV based on FA/ICGA/SD OCT in chronic CSCR (Hage et al, AJO 2015).
OCT-angiography can detect the presence of CNV in 20% of eyes with flat irregular PED in CSCR patients. Further studies with large sample size are needed to evaluate the sensitivity and specificity of CNV detection on OCT-A compared with FA/ICGA in chronic CRSC.
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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