Literature DB >> 32317465

Commentary: Multicolor imaging: A new imaging tool in central serous chorioretinopathy.

Ramesh Venkatesh1, Arpitha Pereira1, Sajjan Sangai1, Vivek Singh1, Akhila Sridharan1.   

Abstract

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Year:  2020        PMID: 32317465      PMCID: PMC7350457          DOI: 10.4103/ijo.IJO_2190_19

Source DB:  PubMed          Journal:  Indian J Ophthalmol        ISSN: 0301-4738            Impact factor:   1.848


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Central serous chorioretinopathy (CSCR) is a hyperpermeable choroidal vascular disease characterized by the serous detachment of the retina and/or retinal pigment epithelium (RPE), usually confined to the macula.[1] In CSCR, the accumulation of the subretinal fluid (SRF) is mainly attributed to the imbalance between the increased choroidal vascular permeability and reduced SRF absorption by the RPE. A combination of imaging features from color fundus photography (CFP), fundus autofluorescence (FAF), fluorescein and indocyanine green angiography, and optical coherence tomography (OCT) are routinely required to detect the mechanism at fault. Both fluorescein and indocyanine green angiography are invasive techniques and can have dye-related complications. Thus, an ideal imaging modality in the diagnosis and treatment of CSCR would be a noninvasive tool, which could identify all the clinical features of CSCR like the presence of leaks, fibrin, pigment epithelium detachment, diffuse retinal pigment epithelial atrophy, and the extent of SRF, simultaneously. Multicolor (MI) scanning laser imaging is a new imaging technique developed by the Spectralis, Heidelberg Engineering, where en face images are generated based on the tissue's reflectance spectrum to the light of different wavelengths. The images are captured by simultaneously scanning the tissue with light of three individual wavelengths—blue (488 nm), green (518 nm), and infrared (815 nm). The different wavelengths penetrate the tissue at varying depths and, thereby, provide structural information from different depths within the retina and choroid.[2] We published our study comparing the utility of MI to the gold standard imaging modalities in identifying the various clinical features in CSCR.[3] In comparison with fluorescein angiography (FA), we found MI to be more effective in identifying the extent of SRF (78% vs 13%). In addition, MI was equally capable of identifying pigment epithelium detachment (100% vs 100%) and retinal pigment epithelial changes (100% vs 100%). Focal leaks were identified in 84% and 97% eyes on MI and FA imaging respectively. The sensitivity of MI in identifying focal retinal pigment epithelial leaks was higher compared to near-infrared autofluorescence (84% vs 34%) and blue wavelength autofluorescence (84% vs 18%) imaging. Govindahari et al. compared various clinical findings in CSCR (SRF, subretinal deposits, RPE atrophy, retinal pigment epithelial detachment [PED], and pachy vessels) on FAF, both qualitatively and quantitatively.[4] They concluded that MI demonstrated better-defined lesions (neurosensory retinal detachment [NSD], PED, RPE atrophy) and a greater number of eyes with PED and pachy vessels in comparison with FAF. Both investigations had a 100% sensitivity in detecting SRF and 100% specificity for subretinal deposits. The study demonstrated the ability of MI to quantitatively and qualitatively define various clinical features in CSCR and the advantages it holds over FAF. Saurabh et al.,[5] in their study, compared the MI imaging signatures vis-à-vis CFP in CSCR to identify SRF, PED, fibrin and RPE atrophy. They concluded that both MI and CFP were inferior to the gold standard in identifying the SRF, PED, and RPE atrophy. However, MI was better than CFP in comparison with the gold standard for these clinical findings in CSCR. Thus, from the various studies available in the literature, it can be concluded that MI is a useful, non-invasive imaging modality in documenting and monitoring various structural changes in eyes with CSCR. MI has some additional advantages as well: 1) It is non-invasive; 2) nondye-based imaging; 3) less photophobic to the patient; 4) can be used in undilated pupil; 5) 55° images gives a larger view of the retinal periphery; 6) can be combined along with OCT to allow simultaneous fundus and cross-sectional imaging, and 7) provides high-contrast images, thus, allowing to image through hazy media-like cataract. In the future, MI has the potential to substitute FA and CFP as the imaging modality of choice in CSCR.
  5 in total

Review 1.  Clinical Application of Multicolor Imaging Technology.

Authors:  Anna C S Tan; Monika Fleckenstein; Steffen Schmitz-Valckenberg; Frank G Holz
Journal:  Ophthalmologica       Date:  2016-07-13       Impact factor: 3.250

2.  Multicolour imaging in central serous chorioretinopathy.

Authors:  Ramesh Venkatesh; Sabitabh Kumar Agarwal; Bharathi Bavaharan; Sajjan Sangai; Kushagra Jain; Santosh Gk Gadde; Vishma Prabhu; Priya Srinivasan; Naresh Kumar Yadav
Journal:  Clin Exp Optom       Date:  2019-09-06       Impact factor: 2.742

Review 3.  Central serous chorioretinopathy.

Authors:  Maria Wang; Inger Christine Munch; Pascal W Hasler; Christian Prünte; Michael Larsen
Journal:  Acta Ophthalmol       Date:  2007-07-28       Impact factor: 3.761

4.  Validation of multicolor imaging signatures of central serous chorioretinopathy lesions vis-a-vis conventional color fundus photographs.

Authors:  Kumar Saurabh; Rupak Roy; Sugandha Goel; Barun Garg; Samarth Mishra
Journal:  Indian J Ophthalmol       Date:  2020-05       Impact factor: 1.848

5.  Multicolor imaging in central serous chorioretinopathy - a quantitative and qualitative comparison with fundus autofluorescence.

Authors:  Vishal Govindahari; Sumit Randhir Singh; Bindu Rajesh; Roberto Gallego-Pinazo; Rosa Dolz Marco; Dhanya V Nair; Unni Nair; Jay Chhablani
Journal:  Sci Rep       Date:  2019-08-13       Impact factor: 4.379

  5 in total

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