En Face Enhanced-Depth Swept-Source Optical Coherence Tomography Features of Chronic Central Serous Chorioretinopathy
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Author(s) • • • • • • • • •
Ferrara, Daniela
Mohler, Kathrin Juliane
Waheed, Nadia
Adhi, Mehreen
Liu, Jonathan Jaoshin
Grulkowski, Ireneusz
Kraus, Martin F.
Baumal, Caroline
Hornegger, Joachim
Fujimoto, James G.
Date Issued
March 2014
Journal
Ophthalmology
Publisher
Elsevier
Citation
Ferrara, Daniela, Kathrin J. Mohler, Nadia Waheed, Mehreen Adhi, Jonathan J. Liu, Ireneusz Grulkowski, Martin F. Kraus, et al. “En Face Enhanced-Depth Swept-Source Optical Coherence Tomography Features of Chronic Central Serous Chorioretinopathy.” Ophthalmology 121, no. 3 (March 2014): 719–726.
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Author's final manuscript
Abstract
Objective
To characterize en face features of the retinal pigment epithelium (RPE) and choroid in eyes with chronic central serous chorioretinopathy (CSCR) using a high-speed, enhanced-depth swept-source optical coherence tomography (SS-OCT) prototype.
Design
Consecutive patients with chronic CSCR were prospectively examined with SS-OCT.
Participants
Fifteen eyes of 13 patients.
Methods
Three-dimensional 6×6 mm macular cube raster scans were obtained with SS-OCT operating at 1050 nm wavelength and 100 000 A-lines/sec with 6 μm axial resolution. Segmentation of the RPE generated a reference surface; en face SS-OCT images of the RPE and choroid were extracted at varying depths every 3.5 μm (1 pixel). Abnormal features were characterized by systematic analysis of multimodal fundus imaging, including color photographs, fundus autofluorescence, fluorescein angiography, and indocyanine-green angiography (ICGA).
Main Outcome Measures
En face SS-OCT morphology of the RPE and individual choroidal layers.
Results
En face SS-OCT imaging at the RPE level revealed absence of signal corresponding to RPE detachment or RPE loss in 15 of 15 (100%) eyes. En face SS-OCT imaging at the choriocapillaris level showed focally enlarged vessels in 8 of 15 eyes (53%). At the level of Sattler's layer, en face SS-OCT documented focal choroidal dilation in 8 of 15 eyes (53%) and diffuse choroidal dilation in 7 of 15 eyes (47%). At the level of Haller's layer, these same features were observed in 3 of 15 eyes (20%) and 12 of 15 eyes (80%), respectively. In all affected eyes, these choroidal vascular abnormalities were seen just below areas of RPE abnormalities. In 2 eyes with secondary choroidal neovascularization (CNV), distinct en face SS-OCT features corresponded to the neovascular lesions.
Conclusions
High-speed, enhanced-depth SS-OCT at 1050 nm wavelength enables the visualization of pathologic features of the RPE and choroid in eyes with chronic CSCR not usually appreciated with standard spectral domain (SD) OCT. En face SS-OCT imaging seems to be a useful tool in the identification of CNV without the use of angiography. This in vivo documentation of the RPE and choroidal vasculature at variable depths may help elucidate the pathophysiology of disease and can contribute to the diagnosis and management of chronic CSCR.
MIT Department
Massachusetts Institute of Technology. Department of Electrical Engineering and Computer Science
Massachusetts Institute of Technology. Research Laboratory of Electronics
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DOI of Published Version
https://doi.org/10.1016/j.ophtha.2013.10.014