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Ryo Obata, Youko Nomura, Xue Tan, Keiko Azuma, Yasuo Yanagi; Obscuration of the inner choroidal layer in central serous chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6388.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate appearance of the choroidal layer in the patients with central serous chorioretinopathy (CSC) using swept-source optical coherence tomography (OCT) and to analyze its relationship with other tomographic or angiographic findings.
Twenty-eight eyes of 27 cases underwent a set of radial scans centered on the fovea with swept-source OCT (DRI OCT-1, Topcon Inc., Tokyo). We assessed appearance in the choroidal layer, and focused on the finding that hyporeflective reflex extending from the outer choroidal layer obscured some parts of the inner layer which corresponds to Sattler layer and choriocapillaris. Moreover, we analyzed the relationship between the obscuration and serous retinal detachment (SRD), foveal choroidal thickness, and the ratio of hyper- to hyporeflective area (L/D ratio) in OCT. We also assessed the findings in fluoresceine angiography (FA) and indocyanine-green angiography (ICGA).
Fifteen and three of 28 eyes had been treated with photodynamic therapy (PDT) and laser photocoagulation, respectively. Inner choroidal obscuration was observed in 15 (54%) of 28 eyes. Comparing the cases with this finding and those without, 33% and 67% of the cases, respectively, had a history of PDT (p=0.008). A higher proportion of the cases with the obscuration showed SRD (69% vs 17%, p=0.008). Additionally, the cases with the finding revealed greater choroidal thickness (364 micrometer vs 295 micrometer beneath the fovea, p=0.03) and lower L/D ratio (p=0.03). Window defects (93%) in FA and hyperpermeability in ICGA (93%) were observed corresponding to the area with obscuration.
We found inner choroidal obscuration in CSC patients using swept-source OCT. The correlation with other findings suggests that inner choroidal obscuration may be associated with exudative changes in the choroid caused by CSC.
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