Sulzbacher Florian, Schütze Christopher, Burgmüller Michael, Vécsei-Marlovits Pia Veronika, Weingessel Birgit
Department of Ophthalmology, Hietzing Hospital, Wolkersbergenstrasse 1, A-1130, Vienna, Austria.
Karl Landsteiner Institute for Process Optimization and Quality Management in Cataract Surgery, Wolkersbergenstrasse 1, Vienna, Austria.
Graefes Arch Clin Exp Ophthalmol. 2019 Aug;257(8):1581-1590. doi: 10.1007/s00417-019-04297-z. Epub 2019 Apr 29.
To evaluate the clinical characteristics of eyes with chronic central serous chorioretinopathy based on swept source optical coherence tomography angiography (SS OCTA).
Twenty-nine eyes presenting with chronic central serous chorioretinopathy (CSC) were examined with the Topcon SS OCTA, using the DRI optical coherence tomography (OCT) Triton machine, and were classified as neovascular or non-neovascular CSC depending on whether a vascular pattern was detected in the outer retina on OCT angiogram. The two groups were compared based on the following clinical findings: best corrected distance and reading visual acuity (BCDVA, best corrected reading acuity (BCRA)), rate of subretinal fluid, intraretinal fluid, hyperreflective flat pigment epithelial detachment (PED), and serous PED.
Of 29 eyes with chronic CSC, 10 (34.5%) showed a neovascular pattern, suggesting neovascular CSC, in the outer retina of SS OCTA. Eyes with neovascular CSC showed a significantly worse initial and final BCDVA, with a mean value of 0.39 ± 0.20 logMAR (Snellen equivalent 20/49) and 0.33 ± 0.36 logMAR (Snellen equivalent 20/43), compared to eyes with non-neovascular CSC with a mean value of 0.16 ± 0.15 logMAR (Snellen equivalent 20/29) and 0.04 ± 0.11 logMAR (Snellen equivalent 20/22) (p < 0.05), respectively. Final mean BCRA was 0.14 ± 0.20 logRAD for non-neovascular CSC compared to 0.34 ± 0.28 logRAD (p = 0.031) for neovascular CSC. The mean time between the first and final visits was 3 years for both groups. The mean anti-VEGF injection rate was 6.4 for neovascular CSC and 2.9 for non-neovascular CSC, whereas 26.3% of non-neovascular CSC eyes had an additional half fluence photodynamic therapy (PDT).
SS OCTA provides a promising CNV detection rate, secondary to chronic CSC, in a clinical setting. Neovascular CSC is associated with a worse outcome in terms of visual and reading acuity compared to non-neovascular CSC.
基于扫频源光学相干断层扫描血管造影（SS OCTA）评估慢性中心性浆液性脉络膜视网膜病变（CSC）患眼的临床特征。
使用拓普康SS OCTA，通过DRI光学相干断层扫描（OCT）Triton机器对29例慢性中心性浆液性脉络膜视网膜病变（CSC）患眼进行检查，并根据OCT血管造影在外层视网膜是否检测到血管模式，将其分为新生血管性或非新生血管性CSC。根据以下临床结果对两组进行比较：最佳矫正远视力和阅读视力（BCDVA，最佳矫正阅读视力（BCRA））、视网膜下液、视网膜内液、高反射扁平色素上皮脱离（PED）和浆液性PED的发生率。
在29例慢性CSC患眼中，10例（34.5%）在SS OCTA的外层视网膜显示新生血管模式，提示为新生血管性CSC。与非新生血管性CSC患眼相比，新生血管性CSC患眼的初始和最终BCDVA明显更差，平均值分别为0.39±0.20 logMAR（Snellen视力相当于20/49）和0.33±0.36 logMAR（Snellen视力相当于20/43），而非新生血管性CSC患眼的平均值分别为0.16±0.15 logMAR（Snellen视力相当于20/29）和0.04±0.11 logMAR（Snellen视力相当于20/22）（p<0.05）。非新生血管性CSC的最终平均BCRA为0.14±0.20 logRAD，而新生血管性CSC为0.34±0.28 logRAD（p = 0.031）。两组首次和末次就诊之间的平均时间均为3年。新生血管性CSC的平均抗VEGF注射率为6.4，非新生血管性CSC为2.9，而26.3%的非新生血管性CSC患眼接受了额外的半量光动力疗法（PDT）。
在临床环境中，SS OCTA对慢性CSC继发的脉络膜新生血管（CNV）具有较高的检测率。与非新生血管性CSC相比，新生血管性CSC在视力和阅读视力方面的预后更差。
