Chorioretinal folds: a proposed diagnostic algorithm

Bagnis, Alessandro; Cutolo, Carlo Alberto; Corallo, G.; Musetti, Donatella; Nicolò, Massimo; Traverso, Carlo Enrico

doi:10.1007/s10792-019-01083-y

Cited by 12 publications

(14 citation statements)

References 27 publications

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“…The sclera in patients with high myopia may not be sufficiently strong to maintain the contour of the posterior globe and make the globe similar to a deflated balloon [ 19 ]. Thus, tractional forces exerted by the inferior oblique muscle at its insertion point located behind the macular area can result in CRFs [ 20 ]. In addition, CRFs occurred at a relatively low IOP.…”

Section: Discussionmentioning

confidence: 99%

Chorioretinal Folds in the Trabeculectomized Eye with Normal Intraocular Pressure after Phacoemulsification

et al. 2021

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Background and Objectives: This case report discusses possible causes of chorioretinal fold (CRF) formation. Materials and Methods: A case report. Results: A 48-year-old man presented with a history of high myopia and primary open-angle glaucoma in both eyes. He underwent a trabeculectomy followed by phacoemulsification in both eyes. Two months later, he complained of blurred vision in the right eye. The intraocular pressure (IOP) was 17 mmHg in the left eye and 9 mmHg in the right eye. Refraction showed a hyperopic shift in both eyes. Slit-lamp examination showed a deep anterior chamber without cells and a well-functional bleb without leakage. Fundus examination revealed CRFs in the macula of the right eye. No papilledema, choroidal lesions, or other retinal lesions were found. Wrinkling of CRFs at the macula, an increase in central foveal thickness, and a fluid cleft were demonstrated by spectral-domain optical coherence tomography. After using steroid eye drops, the IOP in the right eye and refraction in both eyes recovered to the baseline level. Visual acuity improved in both eyes. Conclusions: CRFs in trabeculectomized eyes with normal IOP after phacoemulsification have not been reported. This case demonstrated that the trabeculectomized eye remains at risk of CRF formation, even if the IOP is normal without hypotony. The importance of a detailed fundus examination in patients with unexplained blurred vision may be necessary after having undergone these procedures. The early recognition of the cause of visual loss may facilitate immediate treatment and may avoid irreversible changes with permanent visual loss.

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Section: Discussionmentioning

confidence: 99%

Chorioretinal Folds in the Trabeculectomized Eye with Normal Intraocular Pressure after Phacoemulsification

et al. 2021

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“…OCT, FA, and OCTA provide information regarding the anatomic status of RPE as well as associated changes including leakage and choroidal neovascularization in chorioretinal folds. 14 On the other hand, AF imaging furnishes important information on the functional properties of RPE. Further studies with histopathological correlations may better identify these in-vitro observations.…”

Section: Discussionmentioning

confidence: 99%

Multimodal imaging of chorioretinal folds induced by orbital vascular malformation in two cases

Gündüz

Shields

Bekdemir³

et al. 2020

European Journal of Ophthalmology

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Purpose: To investigate the alterations in the retinal pigment epithelium (RPE) in the crest and trough portions of chorioretinal folds (CRFs) induced by an orbital vascular tumor. Methods: Review of multimodal imaging in two eyes of two patients with globe compression and CRFs from an orbital vascular tumor. Results: Fundus photography demonstrated obliquely extending CRFs with alternating hyperpigmented and hypopigmented linear alterations in both eyes. Fundus autofluorescence (AF) imaging showed obliquely oriented hypoAF lines, incompletely alternating with hyperAF lines. In Case 1, the hyperAF lines had interspersed hypoAF segments and Case 2 had peripapillary mottling of AF. Fluorescein angiography (FA) showed alternating hyper and hypofluorescent lines in the late phase in Case 1. Optical coherence tomography (OCT) documented relative thinning of RPE at the folded crests in Case 1 and preservation of RPE in Case 2. Swept-source OCT angiography (SS-OCTA) demonstrated oblique hyporeflective lines in the outer retina and choriocapillaris layers in Case 2. These findings suggest that the crest of a CRF represents thinned or rarified RPE with hypoAF, transmission hyperfluorescence (FA), partially attenuated RPE layer (OCT), and isoreflectivity (SS-OCTA) while the trough represents compressed RPE with irregular hyperAF, transmission hypofluorescence (FA), thickened RPE layer (OCT), and hyporeflectivity (SS-OCTA). Conclusion: The anatomic and functional status of the RPE in CRFs based on multimodal imaging reveals normal to attenuated RPE with hypofunctionality at the fold crest and compacted, thickened RPE at the trough with segmental functional impairment on AF imaging. Anatomic information regarding CRFs is evident on OCT, FA, and SS-OCTA while the functional status is depicted on AF.

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“…3,4 Nevertheless, CRF have been associated with numerous ocular and extraocular diseases: hypotony, central serous chorioretinopathy, posterior scleritis, uveitis, uveal effusion syndrome, diabetic retinopathy, thyroid-related ophthalmopathy, idiopathic orbital inflammation, autoimmune diseases, intra-cranial hypertension, or Lyme disease. 1,4,5…”

Section: Introductionmentioning

confidence: 99%

“…The reduction of the inner surface of the sclera due to scleral thickening (hypotony and inflammation) or contraction (hyperopia), produces a buckling force that affects the choroid. 6,7 Since the introduction of enhanced depth imaging (EDI), optical coherence tomography (OCT) has become the most specific imaging tool in the diagnosis and characterization of CRF 3,4,8,9 where CRF are shown as undulations of the retina, RPE, and choroid. Recently, optical coherence tomography angiography (OCTA) characteristics in patients with CRF have been reported and the authors described the presence of a linear signal reduction in the choriocapillaris slab in correspondence of the fold.…”

Section: Introductionmentioning

confidence: 99%

Quantitative analysis of retinal and choroidal vasculature in patients with chorioretinal folds secondary to hyperopia

Sargues

Adsuara

Navarro

et al. 2021

European Journal of Ophthalmology

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Introduction: There is a lack of information on quantitative parameters of optical coherence tomography angiography (OCTA) in cases of chorioretinal folds (CRF). The aim of this study was to compare OCTA retinal and choriocapillary vessel density (VD) between normal subjects and patients with CRF. Methods: We conducted an observational retrospective study. A total of 16 eyes of eight patients were recruited (eight eyes with CRF and eight control eyes). Data on best-corrected visual acuity (BCVA), refractive error, central macular thickness (CMT), central subfoveal thickness (CST), and OCTA findings (VD and foveal avascular zone (FAZ) area in superficial capillary plexus (SCP), middle capillary plexus (MCP), and deep capillary plexus (DCP), and VD in choriocapillaris (CC)) were recorded in each eye. Results: Compared with control group, CRF group showed decreased VD in the foveal region of SCP and MCP ( p value 0.003 and 0.001), and increased VD in nasal region of SCP and MCP ( p value 0.02 and 0.001), and in parafoveal area of MCP ( p value 0.005). No differences were found in DCP and CC layers. Furthermore, we observed an enlargement of FAZ in CRF group at SCP and MCP slabs ( p value <0.001 and 0.015). Respect to optical coherence tomography parameters, we demonstrated a thicker choroid in the CRF group ( p value 0.002). Conclusion: To the best of our knowledge, this is the first study reported in the literature quantifying VD of retinal capillary plexus and CC in a group of patients with a diagnosis of CRF secondary to hyperopia.

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Chorioretinal folds: a proposed diagnostic algorithm

Cited by 12 publications

References 27 publications

Chorioretinal Folds in the Trabeculectomized Eye with Normal Intraocular Pressure after Phacoemulsification

Chorioretinal Folds in the Trabeculectomized Eye with Normal Intraocular Pressure after Phacoemulsification

Multimodal imaging of chorioretinal folds induced by orbital vascular malformation in two cases

Quantitative analysis of retinal and choroidal vasculature in patients with chorioretinal folds secondary to hyperopia

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