Fluorescein angiography and fundus autofluorescence imaging discrepancy in patients with chronic central serous chorioretinopathy

Abstract

Purpose : Recently several studies reported about the possibility of using short-wave fundus autofluorescence (AF) along with fluorescein angiography (FA) for pathological changes evaluation in patients with chronic central serous chorioretinopathy (CSC). The aim of the current study was to assess the possible correlations between AF and FA imaging modalities and analyse the predicting ability of AF for structural changes measured by FA with time.

Methods : Seventy one patients (92 eyes) with CSC and AF-FA imaging discrepancy and a follow – up of a minimum of 6 months were included into the retrospective multicentre study. Area of corresponding hyperfluorescent abnormalities in AF and FA images were measured by Heidelberg Software “draw region” tool (Heidelberg Engineering, Heidelberg, Germany) at the 1^st and last visits. Discrepancy in size of areas was estimated using Wilcoxon rank sum test. The correlations between the discrepancy in size of areas and the following parameters: CSC duration, follow – up duration, serous retinal detachment (SRD) persistence, LogMAR BCVA at first and last visits, number and type of therapeutic approaches, were estimated using the Spearman correlation coefficients.

Results : Median age (range) was 42 years (29-72); 81.7% were male. Median follow-up was 22 months (6-107) and median CSC duration was 47 months (9 – 419). Median area of hyperfluorescent abnormalities according to FA increased significantly from 2.40 (0.02 – 17.27) mm² at 1^st visit to 5.22 (0.53 – 25.62) mm² at last visit (p<0.001). Factors significantly associated with the decrease of discrepancy intensity included: follow – up duration, area of hyperfluorescent changes according to AF at 1^st visit, type of therapeutic approaches (monotherapy or combination therapy) (p < 0.001, p = 0.011, p = 0.019, respectively). Based on the linear regression analysis the following model could be used to assess the changes in area of RPE abnormalities with time: 0.389 + 0.674*(AF value at 1^st visit – FA value at 1^st visit) – 0.3*follow – up duration. With a cut-off value of -2.7, the enlargement of hyperfluorescent RPE abnormalities could be predicted with 78.9% sensitivity and 64.9% specificity.

Conclusions : The application of proposed model based on AF results at 1^st visit could predict the enlargement of hyperfluorescent RPE abnormalities measured by FA at last visit in 82.6% of cases.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.