Abstract
Purpose :
To report optical coherence tomography angiography (OCTA) findings in three cases, two active and one inactive, of serpiginous choroidopathy (SC) and describe OCTA changes in response to treatment.
Methods :
Retrospective observational case series of three patients with SC undergoing multimodal imaging, including OCTA. In one treated eye, both pre and post treatment images were compared.
Results :
OCTA of active SC lesions in our series demonstrated a consistent apparent absence of the underlying choriocapillaris layer with variable overlying retinal pigment epithelium (RPE) and outer retinal swelling/disruption. Additionally, in one case, OCTA of an active lesion also demonstrated partial absence of larger choroidal vessels. In the single treated case, post-treatment OCTA imaging of previously active lesions showed partial reappearance of choriocapillaris, especially at lesion margins. In inactive SC, the choriocapillaris, along with the RPE and outer retina, is notably absent.
Conclusions :
The variability of outer retina/RPE thickening along with a consistent absence of choriocapillaris on OCTA imaging suggests that the choriocapillaris is likely the primary site of disease activity in active SC. Post-treatment OCTA images also suggest potential for choroidal remodeling following steroid therapy and lend support to a primary inflammatory etiology. Lastly, for all cases, active and inactive, there may be errors of interpretation given that OCTA is a relatively new technology, as well as errors due to artifact which may ultimately affect assessment of the disease process. Therefore, a definitive conclusion regarding pathogenesis of SC is not elucidated by these findings and further studies must be performed.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.