Abstract
Purpose :
To identify the OCT characteristics of eyes with double layer sign (DLS) that are associated with the presence of OCT angiography (OCTA)-confirmed choroidal neovascularization (CNV) in eyes with central serous chorioretinopathy (CSCR)
Methods :
In this retrospective study, consecutive patients with a clinical diagnosis of CSCR with available OCT and OCTA scans were included. The presence or absence of DLS on OCT defined as a shallow RPE elevation with a minimum length of 1000μm and a maximum height of 100μm in the same frame were recorded. In eyes with DLS, further qualitative characteristic features on OCT including sub-RPE reflectivity and homogeneity, RPE layer irregularity, photoreceptor layers disruption, and subretinal hyperreflective material (SHRM) were graded and analyzed to explore whether one or more of these features can accurately identify CNV. The presence of CNV was confirmed by OCTA. Logistic regression was used to determine the OCT associations of CNV in cases with DLS.
Results :
One hundred and sixty-three eyes with CSCR (age, 55.1±12.2 years) from 132 patients were included in this analysis. DLS was identified in in 94 eyes (57.7%) and CNV was detected in 54 eyes (33.1%). Within the DLS group, 46 eyes (48.9%) had CNV. None of the dimensional parameters of the DLS were significantly associated with CNV on univariable regression. However, hyperreflectivity and nonhomogeneity of the sub-RPE space in the DLS were strong predictors of CNV (Table 1). The presence of SHRM and the absence of serous pigment epithelial detachment (PED) in the OCT scan were also significantly correlated (Table 1) with the detection of CNV on OCTA. Although RPE irregularity and photoreceptor disruption were commonly present in the CSCR eyes, they were not associated with MNV. On multivariable model, only hyperreflectivity (OR, 12.2, p=0.001) and nonhomogeneity (OR, 22.2, p=0.005) of the sub-RPE space, and absence of serous PED (OR, 8.2, p=0.02) were identified as independent OCT predictors of the presence of CNV on OCTA in eyes with DLS (Table 1). The combined significant OCT features had a sensitivity and specificity of 96% and 67%, respectively.
Conclusions :
Double-layer sign with nonhomogeneous hyperreflective sub-RPE space indicated higher probability of the presence of CNV. Interestingly, serous PED seemed to be a protective sign against the development of MNV in CSCR.
This is a 2021 ARVO Annual Meeting abstract.