This study evaluated predictors for choroidal neovascularization (CNV) associated with central serous chorioretinopathy (CSCR) based on multimodal imaging. A retrospective multicenter chart review was conducted on 134 eyes of 132 consecutive patients with CSCR. Eyes were classified as per the multimodal imaging-based classification of CSCR at baseline into simple/complex CSCR and primary episode/recurrent/resolved CSCR. Baseline characteristics of CNV and predictors were evaluated with ANOVA. In 134 eyes with CSCR, 32.8% had CNV (n = 44) with 72.7% having complex CSCR (n = 32), 22.7% having simple (n = 10) and 4.5% having atypical (n = 2). Primary CSCR with CNV were older (58 vs. 47, p = 0.00003), with worse visual acuity (0.56 vs. 0.75, p = 0.01) and of longer duration (median 7 vs. 1, p = 0.0002) than those without CNV. Similarly, recurrent CSCR with CNV were older (61 vs. 52, p = 0.004) than those without CNV. Patients with complex CSCR were 2.72 times more likely to have CNV than patients with simple CSCR. In conclusion, CNV associated with CSCR was more likely in complex CSCR and older age of presentation. Both primary and recurrent CSCR are implicated in CNV development. Patients with complex CSCR were 2.72 times more likely to have CNV than patients with simple CSCR. Multimodal imaging-based classification of CSCR supports detailed analysis of associated CNV.

Background/Objectives: The aim of this study was to quantify the interscan variability of vascular perfusion in patients with diabetic retinopathy (DR) using sequential optical coherence tomography angiography (OCT-A) scans. Methods: Patients with low-grade DR (DRSS score 20) underwent five sequential OCT-A imaging sessions. Vessel perfusion density (VPD) values of the superficial capillary plexus (SCP), intermediate capillary plexus (ICP), deep capillary plexus (DCP), and choriocapillaris (CC) were computed using ImageJ Version 1.54 software via a binarization process. The binarized images were analyzed to compute VPD using vessel density plugins. Inter-session variability was assessed using the coefficient of variation (CV) and intraclass correlation coefficient (ICC). The results were compared with an age-matched group of healthy controls. Results: A total of 16 eyes from 16 patients with DR (6 females, 37.5%) and 16 eyes from healthy controls (6 females, 37.5%) were included. Mean VPD values for SCP, ICP, DCP, and CC in patients with DR were 23.64, 13.64, 15.31, and 36.57, respectively. Corresponding values for the healthy subjects were 37.65, 23.32, 22.05, and 49.00, respectively. No significant differences were found in VPD across consecutive scanning sessions (p > 0.05) in either group. However, significant differences in VPD were observed between patients who were healthy and patients with diabetes. Conclusions: Sequential OCT-A imaging demonstrated no significant inter-session variability in both healthy subjects and subjects with diabetes. The Spectralis OCT-A system showed high reliability for imaging both healthy and diseased conditions.

Background/Objectives: The aim of this study was to evaluate the choroidal vascular response using optical coherence tomography (OCT) in patients with chronic central serous chorioretinopathy (CSCR) during transient increases in blood pressure. Methods: This observational, case–control study enrolled chronic CSCR patients and age-matched healthy controls. OCT scans of the macula were performed at rest and during hand-grip (HG) isometric exercise. Mean ocular perfusion pressure (MOPP) and subfoveal choroidal thickness (SCT) were measured at baseline and during stress. Quantitative OCT assessment included the bright area (BA, stroma), dark area (DA, vascular lumen), and total choroidal area (CA). The choroidal vascularity index (CVI) was calculated as DA/CA to assess vascular response to stress. A comparative analysis between CSCR patients and controls was conducted. Conclusions: MOPP was significantly higher (p = 0.008) at baseline in CSCR patients and further increased under stress compared to controls. SCT and CA were both significantly higher in CSCR patients than in healthy subjects at rest and under stress (p < 0.001), but no change occurred after HG. A significant decrease in CVI (p = 0.005) was noted in controls under stress, but not in CSCR patients. Additionally, a negative correlation between CVI and MOPP was found in healthy subjects (−0.648; p = 0.043). The study demonstrated a choroidal vasoconstrictive response to stress in healthy subjects, as evidenced by a decrease in CVI, but not in CSCR patients. This suggests that CSCR patients may experience impaired choroidal blood flow regulation, resulting in potentially higher perfusion pressures during stress without compensatory vasoconstriction, potentially affecting the choriocapillaris.