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Tytuł:
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Chronic Neovascular Central Serous Chorioretinopathy: A Stress/Rest Optical Coherence Tomography Angiography Study.
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Autorzy:
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Lupidi M; Fondazione per la Macula Onlus, Dipartimento di Neuroscienze Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DINOGMI), University Eye Clinic, Genova, Italy; Department of Biomedical and Surgical Sciences, Section of Ophthalmology, University of Perugia, S. Maria della Misericordia Hospital, Perugia, Italy; Centre Ophtalmologique de l'Odéon, Paris, France.
Fruttini D; Department of Internal Medicine, University of Perugia, S. Maria della Misericordia Hospital, Perugia, Italy.
Eandi CM; Fondazione per la Macula Onlus, Dipartimento di Neuroscienze Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DINOGMI), University Eye Clinic, Genova, Italy; Department of Surgical Sciences, Eye Clinic, University of Torino, Torino, Italy.
Nicolò M; Fondazione per la Macula Onlus, Dipartimento di Neuroscienze Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DINOGMI), University Eye Clinic, Genova, Italy; Clinica Oculistica DINOGMi, Università di Genova, Ospedale Policlinico San Martino, Genova, Italy.
Cabral D; Instituto de Oftalmologia Dr. Gama Pinto, Lisboa, Portugal.
Tito S; Fondazione per la Macula Onlus, Dipartimento di Neuroscienze Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DINOGMI), University Eye Clinic, Genova, Italy.
Cagini C; Department of Biomedical and Surgical Sciences, Section of Ophthalmology, University of Perugia, S. Maria della Misericordia Hospital, Perugia, Italy.
Cardillo Piccolino F; Fondazione per la Macula Onlus, Dipartimento di Neuroscienze Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DINOGMI), University Eye Clinic, Genova, Italy. Electronic address: .
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Źródło:
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American journal of ophthalmology [Am J Ophthalmol] 2020 Mar; Vol. 211, pp. 63-75. Date of Electronic Publication: 2019 Nov 09.
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Typ publikacji:
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Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: 1999- : New York, NY : Elsevier Science
Original Publication: [Chicago, etc., Ophthalmic Pub. Co., etc.]
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MeSH Terms:
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Exercise Test*
Central Serous Chorioretinopathy/*physiopathology
Choroidal Neovascularization/*physiopathology
Adult ; Blood Pressure/physiology ; Central Serous Chorioretinopathy/diagnosis ; Choroid/blood supply ; Choroidal Neovascularization/diagnosis ; Chronic Disease ; Exercise ; Female ; Fluorescein Angiography ; Humans ; Intraocular Pressure/physiology ; Male ; Middle Aged ; Prospective Studies ; Regional Blood Flow/physiology ; Retinal Vessels/physiology ; Sensitivity and Specificity ; Tomography, Optical Coherence ; Visual Acuity/physiology
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Entry Date(s):
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Date Created: 20191113 Date Completed: 20200501 Latest Revision: 20200501
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Update Code:
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20240105
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DOI:
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10.1016/j.ajo.2019.10.033
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PMID:
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31715159
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Purpose: To compare optical coherence tomography-angiography (OCT-A) performed during physical exercise (stress OCT-A) to the basal examination (rest OCT-A) in the imaging of choroidal neovascularization (CNV) in patients with chronic central serous chorioretinopathy (CSCR).
Design: Prospective, cohort study.
Methods: This multicenter study included 29 consecutive patients with chronic CSCR and flat irregular pigment epithelium detachments (FIPEDs). All patients underwent rest and stress OCT-A (i.e., hand-grip test [HGT]). Systemic hemodynamic data were recorded during the examinations. Rest and stress OCT-A in the en-face and cross-sectional views were qualitatively compared to establish the degree of evidence of flow signals due to CNVs. The en-face angiograms underwent additional automated quantitative analysis to assess the rate of change in neovascular parameters during the stress condition.
Results: Blood pressure significantly increased during the HGT (P = 0.001). Considering both the en-face and the cross-sectional images, CNV was identified in 13 eyes with the rest OCT-A and in 22 eyes with the stress OCT-A (P = 0.001). Cross-sectional imaging was more sensitive than en-face imaging in detecting neovascular blood flow signals under both rest (P = 0.125) and stress (P = 0.001) conditions. The quantitative analysis showed a significantly greater neovascular area and fractal dimension on the stress OCT-A (P = 0.002).
Conclusions: Performing OCT-A during HGT enhances the sensitivity of the examination in detecting CNV in chronic CSCR. The increased neovascular perfusion following the induced increase of blood pressure is consistent with choroidal blood flow dysregulation in patients with CSCR and indicates new areas of discussion about CNV in this disease.
(Copyright © 2019 The Author(s). Published by Elsevier Inc. All rights reserved.)
