Optical coherent tomographic angiographic pattern of the deep choroidal layer and choriocapillaris after photodynamic therapy for central serous chorioretinopathy
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To study the changes in the choroidal vascular pattern of the deep choroidal layer and choriocapillaris in the eyes with central serous chorioretinopathy (CSC) before versus after photodynamic therapy (PDT) as visualized by optical coherence tomography angiography (OCTA).
This comparative case series study included patients who underwent a half-dose of PDT as a therapy for CSC. Using OCTA and manually shifting the reference level into the deep choroidal layer, we assessed the density of the deep choroidal vascular layer and choriocapillaris.
The study included 20 patients (17 men; mean age, 43.3 ± 10.9 years), with two patients showing bilateral CSC. In the eyes affected by CSC, the mean vascular density of the deep choroidal layer and choriocapillaris increased significantly from 54.2 ± 6.7% at baseline to 58.0 ± 4.7% at 1 month after PDT (P = 0.002) and from 58.1 ± 2.7% at baseline to 60.5 ± 2.7% at 1 month after PDT (P = 0.004), respectively. The difference between affected and unaffected eyes was significantly larger at baseline than at 1 month after PDT (deep choroidal layer 4.79 ± 6.02 versus 0.39 ± 3.46, P = 0.002; choriocapillaris 4.26 ± 3.94 versus 1.25 ± 3.44, P = 0.002) and larger than at 3 months after baseline (n = 11 patients), when the affected and unaffected fellow eyes no longer differed significantly (P = 0.66 and P = 0.37, respectively). As a corollary, the width of the large choroidal vessels in the deep choroidal layer decreased after the PDT. Comparing assessments by two blinded examiners revealed a kappa value of 0.90, indicating a good agreement for examination of the deep choroidal layer.
In conclusion, OCTA can be helpful to visualize the deep choroidal vascular layer by manually shifting the reference layer deeper into the choroid.
KeywordsOptical coherence tomography angiography OCT angiography Central serous chorioretinopathy Photodynamic therapy Indocyanine green angiography
This study was funded by the Beijing Municipal Administration of Hospitals’ Ascent Plan (code: DFL20150201), Science and Technology Project of Beijing Municipal Science and Technology Commission (Z151100001615052), the National Natural Science Foundation of China (Nr.81570891), the Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (ZYLX201307), the National Natural Science Foundation of China (81272981), the Beijing Natural Science Foundation (7151003), and the Advanced Health Care Professionals Development Project of Beijing Municipal Health Bureau (2014-2-003).
Compliance with ethical standards
Conflict of interest
All authors declare that they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Following the tenets of the Declaration of Helsinki, the research protocol was approved by the Medical Ethics Committee of the Beijing Tongren Hospital.
Informed consent was obtained from all individual participants included in the study.
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