OCT Angiography Fractal Analysis of Choroidal Neovessels Secondary to Central Serous Chorioretinopathy, in a Caucasian Cohort

Rita Serra; Antonio Pinna; Francine Behar-Cohen; Florence Coscas

doi:10.3390/jcm11051443

OCT Angiography Fractal Analysis of Choroidal Neovessels Secondary to Central Serous Chorioretinopathy, in a Caucasian Cohort

J Clin Med. 2022 Mar 6;11(5):1443. doi: 10.3390/jcm11051443.

Authors

Rita Serra^{1

2

3}, Antonio Pinna⁴, Francine Behar-Cohen⁵, Florence Coscas³

Affiliations

¹ Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy.
² Istituto di Ricerca Genetica e Biomedica (IRGB), CNR, Cittadella Universitaria di Cagliari, 09042 Monserrato, Italy.
³ Centre Ophtalmologique de l'Odeon, 113 Bd Saint Germain, 75006 Paris, France.
⁴ Department of Medical, Surgical and Experimental Sciences, Ophthalmology Unit, University of Sassari, 07100 Sassari, Italy.
⁵ Assistance Publique-Hôpitaux de Paris, Department of Ophthalmology, Ophtalmopole, Hôpital Cochin, 75014 Paris, France.

Abstract

Central serous chorioretinopathy (CSCR) can be complicated by different types of choroidal neovascularization (CNV). The purpose of this study was to investigate the incidence and quantitative optical coherence tomography angiography (OCT-A) features of CSCR-related CNVs.

Methods: This was a retrospective multicenter study including 102 eyes of 102 Caucasian patients with acute or complex CSCR. All patients underwent a comprehensive ophthalmological examination. Quantitative OCT-A parameters, including vascular perfusion density (VPD), fractal dimension (FD), and lacunarity (LAC), were measured in CNV eyes.

Results: Forty eyes (39.2%) had acute CSCR, whereas the remaining sixty-two (60.8%) had complex CSCR. CNV was observed in 37 (36.27%) eyes, all of which had the complex form. CNVs were classified as type 1 CNV in 11/37 (29.73%) cases and as polypoidal choroidal vasculopathy (PCV) in the remaining 26/37 (70.27%). Overall, the mean VPD, FD, and LAC of CSCR-related CNVs were 0.52 ± 0.20%, 1.44 ± 0.12, and 2.40 ± 1.1, respectively. No significant difference between type 1 CNV and PCV was found.

Conclusion: Complex CSCR is often complicated by type 1 CNV and PCV with similar neovascular architecture and branching complexity, a finding supporting the idea that they might be different stages of the same neovascular process. Future OCT-A fractal analysis-based studies that also include other relevant parameters, such as demographics, presentation, morphology on multimodal imaging, and response to treatment, are necessary before drawing any definitive conclusions.

Keywords: central serous chorioretinopathy; fractal analysis; indocyanine green angiography; optical coherence tomography angiography; polypoidal choroidal vasculopathy; type 1 choroidal neovascularization.