Abstract
Purpose :
To determine agreement between optical coherence tomography angiography (OCTA) and indocyanine green angiography (ICGA) in patients with central serous chorioretinopathy (CSC).
Methods :
This cross-sectional observational clinical study included 44 patients with CSC. All eyes underwent best-corrected visual acuity (BCVA), OCTA, ICGA and fluorescein angiography (FA). OCTA was analyzed for the presence of abnormal findings and compared to the other imaging modalities.The OCTA and ICGA images were aligned by translating and rescaling to match three marking points on both modalities. OCTA and ICGA guided PDT treatment area was determining by annotating a circumcircle covering abnormal area related to SRFWe used Jaccard index (JI) to describe the intergrader agreement and the spatial correspondence of abnormalities in enface OCTA and ICGA
Results :
There are 3 main abnormal findings of chronic CSC on choriocapillaris enface OCTA: A. coarse granulated hyper-reflectant area, B. roundish dark halo around hyper-reflectant area, C. coarse granulated hypo-reflectant area inside the hyper-reflectant area. Type A area in OCTA was larger than hyperfluorescent area in ICGA (8.25±4.76mm2 vs 5.87±4.27mm2,P<0.01) with good agreement with the hyperfluorescent area in ICGA in 70% eyes. Bland-Altman analysis revealed morderate agreement of the measurement of Type A area in OCTA and the hyperfluorescent area in ICGA (JI>0.7).The type B area were all corresponding with the SRF on OCT. Those eyes with halo have significant thicker SRF than those did not have halo.The area of type C abnormality on OCTA were all larger than the hypo-reflective area on ICGA. Abnormal tangled vascularization within double layer sign was found in 7 eyes(21%),all of them were over 50 yrs old.
Conclusions :
There are 3 main abnormal findings of chronic CSC on choriocapillaris enface OCTA. High reflectant area on OCTA showed good agreement with hyperpermeability area on ICGA in 70% eyes. OCTA can detecte abnormal tangled vascularization which was not visible with other imaging techniques in 20% of chronic CSC patients with DLS. Further investigation is needed to evaluate the feasibility to use OCTA guided PDT for CSC patients.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.