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Evaluation of the choriocapillaris after photodynamic therapy for chronic central serous chorioretinopathy. A review of optical coherence tomography angiography (OCT-A) studies

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Abstract 

Purpose

Emerging evidence suggests that choroidal microcirculation and microstructural changes after verteporfin photodynamic therapy (vPDT) for chronic central serous chorioretinopathy (CSC) can be shown in detail using OCT-Angiography (OCT-A). The use of OCT-A for the examination of choriocapillaris (CC) has attracted significant attention as the technique offers potential explanations for the effects of vPDT on choroidal tissue.

Methods

A meticulous literature search was performed in the PubMed database without restriction on year of publication until June 2021. The reference list of all electronically retrieved articles was carefully reviewed for potentially relevant articles that had not been identified.

Results

We identified and reviewed 11 studies reporting a comprehensive update on microvasculature and morphologic changes of the CC layer as seen on OCT-A in chronic CSC. The reviewed articles extensively analyze both the qualitative and quantitative characteristics of the CC flow pattern after applying vPDT safety-enhanced protocols. The changes in the CC plexus indicate the potential of beneficial or deleterious treatment effect on choroidal tissue remodeling. The reviewed series have revealed variability of flow pattern, vessel density, and perfusion of the CC over time.

Conclusion

The CC plexus alterations during the post-vPDT period in chronic CSC may imply the treatment effect on choroidal tissue, indicating the potential of anatomical or functional recovery over time. The reviewed literature may confirm the diagnostic value of OCT-A in the assessment of the pathophysiology of eyes with CSC.

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Authors and Affiliations

  1. Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Stavrou Niarchou Avenue, 45500, Ioannina, Greece

    Evita Evangelia Christou, Andreas Katsanos & Maria Stefaniotou

  2. Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece

    Panagiotis Stavrakas

  3. Department of Ophthalmology, University Hospital of Alexandroupolis, Alexandroupoli, Greece

    Vassilios Kozobolis

  4. Eye Institute of Thrace, Democritus University of Thrace, Komotini, Greece

    Vassilios Kozobolis

  5. First Department of Ophthalmology, General Hospital of Athens G. Gennimatas, Medical School, National and Kapodistrian University of Athens, Athens, Greece

    Ilias Georgalas

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  1. Evita Evangelia Christou
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  2. Panagiotis Stavrakas
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  3. Vassilios Kozobolis
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  4. Andreas Katsanos
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Correspondence to Evita Evangelia Christou.

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All authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

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Andreas Katsanos has to report lecture fees and congress expenses by Santen, Vianex, Zwitter, and research grant by Laboratoires Thea. The other authors have no disclosures to report.

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Christou, E.E., Stavrakas, P., Kozobolis, V. et al. Evaluation of the choriocapillaris after photodynamic therapy for chronic central serous chorioretinopathy. A review of optical coherence tomography angiography (OCT-A) studies. Graefes Arch Clin Exp Ophthalmol 260, 1823–1835 (2022). https://doi.org/10.1007/s00417-022-05563-3

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  • DOI: https://doi.org/10.1007/s00417-022-05563-3

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