Ophthalmology in China ›› 2022, Vol. 31 ›› Issue (4): 266-271.doi: 10.13281/j.cnki.issn.1004-4469.2022.04.004

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Characteristics differences of the retinal pigment epithelium-Bruch’s membrane-choroidal capillary complex in different subtype of central serous chorioretinopathy

Zhou Rong1, Sun Zuhua1, Lin Bing1, Jin Zibing2, Liu Xiaoling1   

  1. 1Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou 325000, China; 2 Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing  Key Laboratory of Ophthalmology and Visual Sciences, Beijing 100730, China

  • Received:2022-04-18 Online:2022-07-25 Published:2022-07-29
  • Contact: Liu Xiaoling, Email: drliuxiaolin@163.com
  • Supported by:
    National Key R & D Plan (2017YFA010530, 2020YFC2008200)

Abstract:  Objective To evaluate the imaging characteristics of retinal pigment epithelium-Bruch’s membrane complex in acute and chronic central serous chorioretinopathy (CSC) using high-definition B-scan optical coherence tomography angiography (OCTA) Dense ART (DART) scan modality.  Design Retrospective case series. Participants 43 patients that presented with acute (12 cases), chronic (16 cases) or neovascular (15 cases) CSC were reviewed. Methods Patients’ medical records were reviewed. All of the patient underwent multimodal fundus imaging including B-scan optical coherence tomography(OCT), fluorescein angiography, indocyanine green angiography, and OCTA. The Dense DART scan modality, an updated software feature of Heidelberg SPECTRALIS OCT2, was used to assess the cross-sectional retinal pigment epithelium-Bruch’s membrane complex and acquire high-definition B-scan OCTA images. Main Outcome Measures Dark zone under Bruch’s membrane, flat irregular retinal pigment epithelial detachments (PED), crossing-sign. Results Hyporeflective signals, also referred as dark zone under Bruch’s membrane, was observed in 10 of 12 (83.3%) acute CSC, and 10 of 31 (32.3%) chronic CSC (P=0.0052).  Of 15 cases with neovascular CSC, 15 cases (15/15, 100%) were accompanied by flat irregular PED (fiPEDs), while only 7 of the 16 cases (7/16, 43.8%) with non-neovascular CSC were accompanied by fiPEDs (P=0.0008). 14 cases with neovascular CSC (14/15, 93.3%) exhibited the crossing-sign, but none of 16 cases with non-neovascular CSC had the crossing-sign (P<0.0001). Conclusion OCTA-DART enables accurate overlay between high-resolution structural B-scan and blood flow signal, which can be applied to the observation of alterations in choroidal capillary blood flow beneath the retinal pigment epithelium-Bruch’s membrane-choroidal capillary complex in eyes with CSC. The blood flow of choroidal capillaries was decreased in acute CSC, but not in chronic choroidal capillaries. The presence of flat irregular PED with concomitant crossing signs contributes to the early diagnosis of CNV in patients with chronic CSC. (Ophthalmol CHN, 2022, 31: 266-271)

Key words: central serous chorioretinopathy, optical coherence tomography angiography