Mandadi Spoorti Krishna Reddy, Singh Sumit Randhir, Sahoo Niroj Kumar, Mishra Sai Bhakti, Sacconi Riccardo, Iovino Claudio, Berger Lieselotte, Munk Marion R, Querques Giuseppe, Peiretti Enrico, Chhablani Jay
Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India.
Ophthalmology, Ospedale San Raffaele, Milano, Italy.
Br J Ophthalmol. 2021 Sep;105(9):1280-1285. doi: 10.1136/bjophthalmol-2018-313576. Epub 2019 Feb 23.
To evaluate the optical coherence tomography angiography (OCTA) features of fellow eyes of patients with unilateral choroidal neovascularisation (CNV) associated with chronic central serous chorioretinopathy (CSCR).
Medical records of patients with chronic CSCR who had undergone OCT angiography of both the eyes were reviewed. Patients with evidence of unilateral CNV detected by conventional imaging (OCT, fluorescein angiography and/or indocyanine green angiography) were included in the study. The OCT and OCTA characteristics of fellow eyes were analysed.
Forty patients (80 eyes-40 fellow eyes) with chronic CSCR with evidence of CNV in one eye were included. Mean age of the patients was 54.9±9.9 years and 82.5 % were males. Twenty-five (62.5%) fellow eyes had flat irregular pigment epithelial detachment on OCT, out of which 21 had internal hyper-reflectivity. A definite vascular network was picked up by OCTA in 9 of these 40 fellow eyes (22.5%) which was not detected on conventional imaging. In addition, two eyes had an ill-defined hyper-reflectivity, which could not be classified as a definite network at that point of time. The networks detected on OCTA in fellow eyes were mostly inactive, suggesting a subclinical neovascularisation.
One-fourth of fellow eyes showed vascular network which could not be diagnosed on conventional imaging which highlights the importance of imaging both the eyes of chronic CSCR for early detection of CNV using OCTA. Further longitudinal studies are needed to assess the clinical course of such subclinical vascular networks in CSCR.
评估单侧脉络膜新生血管（CNV）合并慢性中心性浆液性脉络膜视网膜病变（CSCR）患者对侧眼的光学相干断层扫描血管造影（OCTA）特征。
回顾性分析接受双眼OCT血管造影的慢性CSCR患者的病历。纳入通过传统成像（OCT、荧光素血管造影和/或吲哚菁绿血管造影）检测到单侧CNV的患者。分析对侧眼的OCT和OCTA特征。
纳入40例（80只眼，其中40只为对侧眼）患有慢性CSCR且一眼有CNV证据的患者。患者的平均年龄为54.9±9.9岁，82.5%为男性。25只（62.5%）对侧眼在OCT上有扁平不规则色素上皮脱离，其中21只内部有高反射性。在这40只对侧眼中，有9只（22.5%）通过OCTA检测到明确的血管网络，而传统成像未检测到。此外，有两只眼有不明确的高反射性，在当时无法归类为明确的网络。对侧眼中通过OCTA检测到的网络大多不活跃，提示为亚临床新生血管形成。
四分之一的对侧眼显示出传统成像无法诊断的血管网络，这突出了对慢性CSCR患者双眼进行成像以使用OCTA早期检测CNV的重要性。需要进一步的纵向研究来评估CSCR中这种亚临床血管网络的临床病程。
