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OCT Angiography Allows Visualization Of Abnormal Vessels In Central Serous Retinopathy

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What is added by OCT Angiography (OCTA)?

• OCTA aids in the identification of CNV that is often difficult to diagnose in central serous retinopathy (CSR).1

How does OCTA change patient care?

• OCTA provides visualization of CNV, allowing for timely referral to a retina specialist.
• In eyes where CNV is not present, patients can be confidently managed until a referral is needed.

CASE HISTORY

• 66 year-old white male diagnosed with CSR four years prior
• Three years after the CSR diagnosis, he reported that his past symptomatology had resolved but that he was beginning to sense subtle vision changes

Figure1

FIGURE 1

Figure2

FIGURE 2: Non-exudative lesion at the location where the central serous had resided 3 years prior 

Figure3

FIGURE 3: OCT and OCTA scans from 2018 (left) and 2019 (right)

CLINICAL FINDINGS

• Funduscopy showed a mottled, discolored, atrophic appearance to the macula
• OCT was obtained for serial comparison and showed no evidence of serous fluid; however, there was a hyper-reflective elevated lesion extending anteriorly from the RPE (FIGURE 1)

OCTA ASSESSMENT 

AngioVue® OCTA confirmed the presence of a small occult, non-exudative lesion at the location where the central serous had resided 3 years prior (FIGURE 2). The patient was referred to the retina specialist and treatment was not indicated due to the absence of active leakage.


One year later, the patient returned for his annual examination. He reported a new recurrence of distorted vision OS. Once again, there was serous elevation and discoloration at the macula. OCT confirmed the resurgence of a fluid-filled serous pocket with adjacent distortion and anatomic changes to the RPE. OCTA showed a small neovascular membrane in the choriocapillaris and change analysis with AngioAnalytics™ flow area measurement allowed for sequential analysis of the lesion size (FIGURE 3)

CONCLUSION 

OCTA allowed for the identification and serial monitoring of a chronic central serous that converted to neovascular activity. 
This new information facilitated enhanced co-management of the patient with his retina specialist.

Learn More About OCTA in Daily Practice

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PN 300-54004 | Case Study Courtesy of Julie Rodman, OD, MS, FAAO | 1. Bonini Filho M, de Carlo T, Ferrara D, Adhi M, Baumal C, Witkin A, Reichel E, Duker J, Waheed N. Association of Choroidal Neovascularization and Central Serous Chorioretinopathy with Optical Coherence Tomography Angiography. JAMA Ophthalmol. 2015 August ; 133(8): 899–906

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