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Three-dimensional choroidal vascularity index in acute central serous chorioretinopathy using swept-source optical coherence tomography

  • Jingyuan Yang
  • Erqian Wang
  • Mingzhen Yuan
  • Youxin ChenEmail author
Retinal Disorders
  • 46 Downloads

Abstract

Purpose

To evaluate the three-dimensional choroidal vascularity index (CVI) in the eyes with treatment-naïve acute central serous chorioretinopathy (CSC) using swept-source optical coherence tomography (SS OCT).

Methods

In this prospective cross-sectional study, OCT and OCT angiography covered an area of 12 × 12 mm centered on the fovea. Three-dimensional CVI was defined as the ratio of the choroidal vascular luminal volume to the total choroidal volume. The location of pigment epithelial detachment (PED) and the area with abnormal perfusion at choriocapillary layer were compared with the distribution of the three-dimensional CVI.

Results

Thirty-two eyes with treatment-naïve acute CSC, 18 fellow eyes, and 48 control eyes were enrolled. Three-dimensional CVI had good repeatability on control eyes, with a coefficient of variation of 0.166. The mean CVI in the scan area was 0.35 in the eyes with CSC, 0.34 in the fellow eyes of CSC, and 0.30 in the control eyes. The overall CVI in the control eyes was significantly lower than that in the eyes with CSC and that in fellow eyes (P < 0.001 and P = 0.006, respectively). The eyes with CSC and the fellow eyes had significantly higher CVI values at the posterior pole and the drainage routes of choroidal veins. In the eyes with CSC, PEDs and choriocapillary with abnormal perfusion colocalized with the dilated choroidal vessels, which had high three-dimensional CVI values.

Conclusion

Increased three-dimensional CVI suggested an increased vascular component in the eyes with CSC and in fellow eyes. The three-dimensional CVI is a useful imaging marker of choroidal diseases that volumetrically assesses the choroidal vasculature and might advance our understanding of CSC pathophysiology.

Keywords

Central serous chorioretinopathy Choroid Choroidal vascularity index Optical coherence tomography 

Notes

Acknowledgments

Thanks are due to Cheng Yan, Hongxia Chang, Jiayin Wang, and Shan Wu for collecting data and supporting this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Supplementary material

417_2019_4524_Fig5_ESM.png (1.1 mb)
Supplementary Fig.

Coefficient of variation of the choroidal vascularity index (CVI) in 12 × 12 mm girds in control eyes and fellow eyes of central serous chorioretinopathy. The left halves of these tables had relatively less CVI values. (PNG 1142 kb)

417_2019_4524_MOESM1_ESM.tif (3.2 mb)
High resolution image (TIF 3257 kb)

References

  1. 1.
    Daruich A, Matet A, Dirani A, Bousquet E, Zhao M, Farman N, Jaisser F, Behar-Cohen F (2015) Central serous chorioretinopathy: recent findings and new physiopathology hypothesis. Prog Retin Eye Res 48:82–118.  https://doi.org/10.1016/j.preteyeres.2015.05.003 CrossRefPubMedGoogle Scholar
  2. 2.
    Dansingani KK, Balaratnasingam C, Naysan J, Freund KB (2016) En face imaging of pachychoroid spectrum disorders with swept-source optical coherence tomography. Retina 36:499–516.  https://doi.org/10.1097/iae.0000000000000742 CrossRefPubMedGoogle Scholar
  3. 3.
    Agrawal R, Chhablani J, Tan KA, Shah S, Sarvaiya C, Banker A (2016) Choroidal vascularity index in central serous chorioretinopathy. Retina 36:1646–1651.  https://doi.org/10.1097/iae.0000000000001040 CrossRefPubMedGoogle Scholar
  4. 4.
    Lane M, Moult EM, Novais EA, Louzada RN, Cole ED, Lee B, Husvogt L, Keane PA, Denniston AK, Witkin AJ, Baumal CR, Fujimoto JG, Duker JS, Waheed NK (2016) Visualizing the choriocapillaris under drusen: comparing 1050-nm swept-source versus 840-nm spectral-domain optical coherence tomography angiography. Invest Ophthalmol Vis Sci 57:Oct585–Oct590.  https://doi.org/10.1167/iovs.15-18915 CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Copete S, Flores-Moreno I, Montero JA, Duker JS, Ruiz-Moreno JM (2014) Direct comparison of spectral-domain and swept-source OCT in the measurement of choroidal thickness in normal eyes. Br J Ophthalmol 98:334–338.  https://doi.org/10.1136/bjophthalmol-2013-303904 CrossRefPubMedGoogle Scholar
  6. 6.
    Liegl R, Ulbig MW (2014) Central serous chorioretinopathy. Ophthalmologica 232:65–76.  https://doi.org/10.1159/000360014 CrossRefPubMedGoogle Scholar
  7. 7.
    Daruich A, Matet A, Behar-Cohen F (2017) Central serous chorioretinopathy. Dev Ophthalmol 58:27–38.  https://doi.org/10.1159/000455267 CrossRefPubMedGoogle Scholar
  8. 8.
    Agrawal R, Gupta P, Tan KA, Cheung CM, Wong TY, Cheng CY (2016) Choroidal vascularity index as a measure of vascular status of the choroid: measurements in healthy eyes from a population-based study. Sci Rep 6:21090.  https://doi.org/10.1038/srep21090 CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Rasheed MA, Goud A, Mohamed A, Vupparaboina KK, Chhablani J (2018) Change in choroidal vascularity in acute central serous chorioretinopathy. Indian J Ophthalmol 66:530–534.  https://doi.org/10.4103/ijo.IJO_1160_17 CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Ambiya V, Goud A, Rasheed MA, Gangakhedkar S, Vupparaboina KK, Chhablani J (2018) Retinal and choroidal changes in steroid-associated central serous chorioretinopathy. Int J Retina Vitreous 4:11.  https://doi.org/10.1186/s40942-018-0115-1 CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Agrawal R, Wei X, Goud A, Vupparaboina KK, Jana S, Chhablani J (2017) Influence of scanning area on choroidal vascularity index measurement using optical coherence tomography. Acta Ophthalmol 95:e770–e775.  https://doi.org/10.1111/aos.13442 CrossRefPubMedGoogle Scholar
  12. 12.
    Chinn SR, Swanson EA, Fujimoto JG (1997) Optical coherence tomography using a frequency-tunable optical source. Opt Lett 22:340–342CrossRefGoogle Scholar
  13. 13.
    Kogure K, David NJ, Yamanouchi U, Choromokos E (1970) Infrared absorption angiography of the fundus circulation. Arch Ophthalmol 83:209–214CrossRefGoogle Scholar
  14. 14.
    van Velthoven ME, Verbraak FD, Garcia PM, Schlingemann RO, Rosen RB, de Smet MD (2005) Evaluation of central serous retinopathy with en face optical coherence tomography. Br J Ophthalmol 89:1483–1488.  https://doi.org/10.1136/bjo.2005.073056 CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Cheung CMG, Lai TYY, Ruamviboonsuk P, Chen SJ, Chen Y, Freund KB, Gomi F, Koh AH, Lee WK, Wong TY (2018) Polypoidal choroidal vasculopathy: definition, pathogenesis, diagnosis, and management. Ophthalmology 125:708–724.  https://doi.org/10.1016/j.ophtha.2017.11.019 CrossRefPubMedGoogle Scholar
  16. 16.
    Chen FK, Viljoen RD, Bukowska DM (2016) Classification of image artefacts in optical coherence tomography angiography of the choroid in macular diseases. Clin Exp Ophthalmol 44:388–399.  https://doi.org/10.1111/ceo.12683 CrossRefPubMedGoogle Scholar
  17. 17.
    Singh SR, Invernizzi A, Rasheed MA, Cagini C, Goud A, Vupparaboina KK, Cozzi M, Lupidi M, Chhablani J (2018) Wide-field choroidal vascularity in healthy eyes. Am J Ophthalmol 193:100–105.  https://doi.org/10.1016/j.ajo.2018.06.016 CrossRefPubMedGoogle Scholar
  18. 18.
    Hirami Y, Tsujikawa A, Sasahara M, Gotoh N, Tamura H, Otani A, Mandai M, Yoshimura N (2007) Alterations of retinal pigment epithelium in central serous chorioretinopathy. Clin Exp Ophthalmol 35:225–230.  https://doi.org/10.1111/j.1442-9071.2006.01447.x CrossRefPubMedGoogle Scholar
  19. 19.
    Yang L, Jonas JB, Wei W (2013) Optical coherence tomography-assisted enhanced depth imaging of central serous chorioretinopathy. Invest Ophthalmol Vis Sci 54:4659–4665.  https://doi.org/10.1167/iovs.12-10991 CrossRefPubMedGoogle Scholar
  20. 20.
    Hiroe T, Kishi S (2018) Dilatation of asymmetric vortex vein in central serous chorioretinopathy. Ophthalmol Retina 2:152–161.  https://doi.org/10.1016/j.oret.2017.05.013 CrossRefPubMedGoogle Scholar
  21. 21.
    Zhou H, Chu Z, Zhang Q, Dai Y, Gregori G, Rosenfeld PJ, Wang RK (2018) Attenuation correction assisted automatic segmentation for assessing choroidal thickness and vasculature with swept-source OCT. Biomed Opt Express 9:6067–6080.  https://doi.org/10.1364/boe.9.006067 CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Qu Y, Gong D, Yu W, Dong F (2017) Characteristics of the choriocapillaris layer in optical coherence tomography angiography of acute central serous chorioretinopathy. Ophthalmic Surg Lasers Imaging Retina 48:1000–1005.  https://doi.org/10.3928/23258160-20171130-07 CrossRefPubMedGoogle Scholar
  23. 23.
    De Bats F, Cornut PL, Wolff B, Kodjikian L, Mauget-Faysse M (2018) Dark and white lesions observed in central serous chorioretinopathy on optical coherence tomography angiography. Eur J Ophthalmol 28:446–453.  https://doi.org/10.1177/1120672118758401 CrossRefPubMedGoogle Scholar
  24. 24.
    Nicolo M, Rosa R, Musetti D, Musolino M, Saccheggiani M, Traverso CE (2017) Choroidal vascular flow area in central serous chorioretinopathy using swept-source optical coherence tomography angiography. Invest Ophthalmol Vis Sci 58:2002–2010.  https://doi.org/10.1167/iovs.17-21417 CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical CollegeChinese Academy of Medical SciencesBeijingChina
  2. 2.Key Laboratory of Ocular Fundus DiseasesChinese Academy of Medical SciencesBeijingChina

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