Ultra-widefield imaging with autofluorescence and indocyanine green angiography in central serous chorioretinopathy.

Abstract

PURPOSE:

To describe the spectrum of ultra-widefield autofluorescence (AF) and indocyanine green (ICG) angiographic findings in central serous chorioretinopathy (CSC).

DESIGN:

Retrospective observational case series.

METHODS:

In 37 patients, 65 eyes with CSC from 2 vitreoretinal clinical practices were imaged using ultra-widefield AF and 24 of these eyes with ultra-widefield ICG angiography. Images were correlated with clinical findings and spectral-domain optical coherence tomography (OCT).

RESULTS:

In 37 (57%) eyes, a variety of altered AF patterns, including gravitational tracts, extended beyond the posterior 50 degrees of retina. Hyper-AF corresponded to areas of subretinal fluid (SRF) on spectral-domain OCT and was found to persist in 44 (70%) eyes for up to 8 years despite resolution of SRF. These areas corresponded to outer retinal atrophy with viable retinal pigment epithelium (RPE) on spectral-domain OCT and may be explained by the unmasking of normal background RPE AF. Ultra-widefield ICG angiography revealed dilated choroidal vessels and choroidal hyperpermeability in areas corresponding to altered AF on ultra-widefield AF in all 24 eyes. In 20 (83.3%) eyes, dilated vessels were observed in association with 1 or more congested vortex veins ampullas, suggesting that outflow congestion may be a contributing factor to the pathogenesis of CSC.

CONCLUSIONS:

Ultra-widefield AF and ICG angiography in CSC revealed more widespread disease in a single image than with standard field imaging and may be useful for identifying peripheral areas of previous or ongoing SRF and choroidal hyperpermeability that can assist in the diagnosis of CSC, surveillance of recurrent disease and treatment of active disease.

• Authors: Claudine E Pang, Vinnie P Shah, David Sarraf, K Bailey Freund
• Journal: American journal of ophthalmology (Am J Ophthalmol) Vol. 158 Issue 2 Pg. 362-371.e2 (Aug 2014) ISSN: 1879-1891 [Electronic] United States
• PMID: 24794091 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 Elsevier Inc. All rights reserved.

Chemical References

• Coloring Agents
• Indocyanine Green

Topics

• Adult
• Aged
• Central Serous Chorioretinopathy (diagnosis, physiopathology)
• Coloring Agents
• Diagnosis, Differential
• Female
• Fluorescein Angiography (methods)
• Follow-Up Studies
• Fundus Oculi
• Humans
• Indocyanine Green
• Male
• Middle Aged
• Optical Imaging (methods)
• Reproducibility of Results
• Retinal Pigment Epithelium (pathology)
• Retrospective Studies
• Severity of Illness Index
• Tomography, Optical Coherence (methods)
• Visual Acuity