gms | German Medical Science

Purpose: To detect and describe retinal and choroidal OCT angiography findings in patients with Serpiginous Choroiditis (SC).

Background: The Optical Coherence Tomography Angiography (OCT-A) is a new 3D non-invasive diagnostic method, which allows a detailed study of the vascular perfusion in all retinal and choroidal layers via motion contrast imaging. Its limitations include the lack of detection of fluid dynamics (Pooling, Staining, Leakage) and segmentation errors.

Methods: Thirteen eyes from 7 consenting patients (3 males) of our clinic diagnosed with SC underwent a OCT-A, which were analyzed and compared with other current and/or previous diagnostic measures such as Enhanced Depth Imaging-OCT (EDI-OCT), Fluorescein Angiography (FAG), Indocyanine Green Angiography (ICGA) and Fundusautofluorescence (FAF). One patient was diagnosed with macular SC, one with atypic SC and 6 with peripapillary SC. The disease was inactive in all patients.

Results: OCT-A in patients with inactive SC represented the lesions and ist borders tridimensionally with great detail. There seemed to be no difference in the angioarchitecture spanning the 3 forms of SC. We were able to discern a loss of the choriocapillaris and then RPE, producing a “window defect”, where the vessels of larger caliber of the choroid became recognizable and ist appearance inverted (“white on black”).

Conclusion: The OCT-A was able to represent the lesions of the choroid and retina in patients with SC, with a high degree of correlation with other diagnostic exams. It should allow the distinction between active/inactive disease and could lead to a better understanding of ist progression.