The noninvasive predictive approach for choroidal vascular diffuse hyperpermeability in central serous chorioretinopathy: Near-infrared reflectance and enhanced depth imaging

Purpose: To investigate near-infrared reflectance (NIR) findings in central serous chorioretinopathy (CSCR) and to predict the choroidal vascular diffuse hyperpermeability (CVDHP) by NIR and enhanced depth imaging spectral-domain optical coherence tomography (EDI SD-OCT) noninvasively. Methods: Retrospective analysis of 52 eyes of 50 CSCR patients with serous macular detachment. All patients received NIR, indocyanine green angiography (ICGA), and EDI SD-OCT. NIR patterns (irregular, defected, masked and enhanced), double layer sign (DLS) in EDI SD-OCT and CVDHP in ICGA were evaluated. In addition, we measured the length of photoreceptor outer segment (LPOS), and subfoveal choroidal thickness (SFCT) by Heidelberg eye explorer software. Moreover, the integrity of the junction of inner segment and outer segment of photoreceptor (IS/OS) was recorded. Results: 42 (80.8%) eyes were identified with CVDHP, and 10 (19.2%) eyes appeared disrupted IS/OS. Irregular NIR pattern was found in 48 (92.3%) eyes, as well as DLS was observed in 37 (71.2%) eyes. In addition, irregular NIR pattern, together with DLS had a significant positive correlation with the occurrence of CVDHP (r = 0.605, p < 0.0001). Moreover, in IS/OS preserved eyes, there was also a significant positive relationship between CVDHP and LPOS (r = 0.599, p < 0.0001). In contrast, SFCT only demonstrated a moderate positive relationship with CVDHP in this group (r = 0.441, p = 0.013 < 0.05). Conclusions: Irregular NIR pattern, DLS and LPOS are qualitative and quantitative indexes for CVDHP. Our study suggests that NIR can detect CVDHP effectively and noninvasively. The combined detection of NIR and EDI SD-OCT is a predictive approach for CSCR patients, as a supplement of ICGA. (C) 2014 Elsevier B.V. All rights reserved.