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Susumu Ishida; Understanding of inflammatory and non-inflammatory choroidal thickening using laser speckle flowgraphy. Invest. Ophthalmol. Vis. Sci. 201657(12):.
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© ARVO (1962-2015); The Authors (2016-present)
Presentation Description :
There are distinctly different types of abnormalities showing choroidal thickening with serous retinal detachment: Vogt-Koyanagi-Harada disease (VKH) as an inflammatory disease and central serous chorioretinopathy (CSC) as a non-inflammatory disorder, known as stemming from sympathetic (adrenergic) etiology or systemic corticosteroid use. On indocyanine green angiography, both clinical entities show choroidal vascular dilatation and hyperpermeability, leading presumably to choroidal thickening. However, we have recently reported laser speckle flowgraphy (LSFG) can distinguish these two disorders in regard to choroidal circulation changes. On LSFG, VKH and CSC showed opposite direction of changes in blood flow velocity, i.e., sequential increase and decrease, respectively, with regression of disease activity. These results may be reflected by the different pathogenesis of the two diseases. VKH at the acute stage has an inflammatory circulation disturbance in the thickened choroid with leukocyte adhesion to inner walls of vessels and massive infiltration into the stroma. In contrast, CSC at the acute stage has an increased hydrostatic pressure in the thickened choroid hyperperfused due to adrenergic vascular dysregulation. We have so far confirmed similar trends in several other clinical entities, such as serpiginous choroiditis and punctate inner choroidopathy as inflammatory diseases and hypertensive choroidopathy with non-inflammatory etiology. In this presentation, choroidal circulatory changes in inflammatory and non-inflammatory diseases with choroidal thickening will be highlighted and contrasted using LSFG.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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