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. 2020 Jun 30;20(1):258.
doi: 10.1186/s12886-020-01527-5.

Optical coherence tomography angiography (OCTA) findings in Serpiginous Choroiditis

Sergio Macedo  1 , Dominika Pohlmann  2 , Matthias Lenglinger  2 , Uwe Pleyer  2 , Antonia M Joussen  2 , Sibylle Winterhalter  2
Affiliations

Optical coherence tomography angiography (OCTA) findings in Serpiginous Choroiditis

Sergio Macedo et al. BMC Ophthalmol. .

Abstract

Background: To describe changes in the retina/choroid in patients with Serpiginous Choroiditis (SC) by Optical Coherence Tomography Angiography (OCTA) in a multimodal imaging approach.

Methods: Prospective, monocentric study of 24 eyes of 12 consenting patients diagnosed with SC, who underwent OCTA, which was analyzed and compared to other methods such as enhanced depth imaging-OCT, fluorescein angiography, indocyanine green angiography, and fundus autofluorescence.

Results: The study group consisted of 9 patients with peripapillary SC, 1 macular SC, and 2 atypical cases. All eyes presented an inactive SC confirmed by standard imaging. OCTA demonstrated the lesions tridimensionally in great detail. There was no difference in the angioarchitecture among the 3 forms of SC. A loss of the choriocapillaris/retinal pigment epithelium left a "window-defect", where the vessels of larger caliber of the choroid became recognizable and their appearance inverted ("white-on-black"). A relationship between the presence of segmentation errors (SE) in the slabs and low visual acuity was established with a one-way ANOVA.

Conclusions: OCTA was able to non-invasively assess vascular lesions of the choroid/retina in patients with SC with a high degree of correlation to other diagnostic modalities. Consequent long-term assessments could lead to a better understanding of disease progression.

Keywords: Fluorescein angiography; Fundus autofluorescence; Indocyanin green angiography; Optical coherence tomography angiography; Posterior uveitis; Serpiginous Choroiditis.

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Conflict of interest statement

AMJ has served as principal investigator or consultant for: Allergan, Novartis, Bayer, Heidelberg engineering. UP has served as principal investigator or consultant for: Abbvie, Alcon, Allergan, Novartis, Santen, Thea. SW has served as consultant for: Allergan, Novartis, Bayer, MSD, Heidelberg engineering.

DP has served as consultant for: Allergan, Heidelberg engineering. The remaining authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Multimodal imaging of a 53-year-old female patient with peripapillary Serpiginous Choroiditis, showing the clear loss of choriocapillaris/RPE/EPIS/COST nasal to the fovea (arrow) and the centrifugal progression of the disease from the optic disc. Representations with an angle of 30° of SD-EDI-OCT of the macula (A), FAF (B), and FA/ICGA (C)
Fig. 2
Fig. 2
Choroidal changes in SC. Segmentation of the retina showing a defect (asterisk) of the RPE and choriocapillaris (a), and just the choriocapillaris in greater detail (b). The OCT angiograms are projections of the retina between the automatically segmented outer plexiform layer and the manually corrected basal membrane in (a) and at an imaginary line running 10 μm below and parallel to the manually segmented retinal pigment epithelium in (b), shown in the corresponding OCT B-Scans below
Fig. 3
Fig. 3
Choroidal changes in SC (continued). The hypoperfusion seen in Fig. 2 leads to a window defect responsible for the “White on Black effect” in the Haller’s Layer seen here at the top of (a). b displays the same defect at the level of the retinal pigment epithelium, showing that the area corresponding to the foveola was spared. The OCT angiograms are projections of the retina at an imaginary line running 140 μm inferiorly and parallel to the basal membrane in (a) and through the manually segmented retinal pigment epithelium in (b), shown in the corresponding OCT B-Scans below
See this image and copyright information in PMC

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