Multimodal Imaging and Choroidal Volumetric Changes After Half-fluence PDT in Central Serous Chorioretinopathy

Abstract

Purpose: The purpose of this study was to identify SD-OCT changes that correspond to leakage on fluorescein (FA) and indocyanine angiography (ICGA) and evaluate effect of half-fluence photodynamic therapy (PDT) on choroidal volume in chronic central serous choroidoretinopathy (CSC).

Methods: Retrospective analysis of patients with chronic CSC who had undergone PDT. Baseline FA and ICGA images were overlaid on SD-OCT to identify OCT correlates of FA or ICGA hyperfluorescence. Choroidal volume was evaluated in a subgroup of eyes before and after PDT.

Results: Twenty eyes were evaluated at baseline, of which seven eyes had choroidal volume evaluations at baseline and 3 months following PDT. SD-OCT changes corresponding to FA hyperfluorescence were subretinal fluid (73%), RPE microrip (50%), RPE double-layer sign (31%), RPE detachment (15%), and RPE thickening (8%). ICGA hyperfluoresence was correlated in 93% with hyperreflective spots in the superficial choroid. Choroidal volume decreased from 9.35 ± 1.99 to 8.52 ± 1.92 and 8.04 ± 1.7 mm³ (at 1 and 3 months post PDT, respectively, p ≤ 0.001).

Conclusions: We identified specific OCT findings that correlate with FA and ICGA leakage sites. SD-OCT is a valuable tool to localize CSC lesions and may be useful to guide PDT treatment. Generalized choroidal volume decrease occurs following PDT and extends beyond PDT treatment site.

• Central serous choroidoretinopathy
• choroidal thickness
• choroidal volume
• fluorescein angiography
• hyperfluorescence
• indocyanine angiography
• pigment epithelium detachment
• SD-OCT

Declaration of Interest

The authors have no potential conflicts of interest, including relevant financial interests, activities, relationships, and affiliation with any organization or entity with a financial interest to disclose. This work was supported in part by an unrestricted grant from the Macula Foundation, New York City, and by Research to Prevent Blindness Inc., New York. The funding agencies had no role in the design and conduct of this study; collection, management, analysis, and interpretation of the data; and preparation, review or approval of the manuscript and the decision to submit the manuscript for publication.