Abstract
Purpose: :
Central serous chorioretinopathy (CSC) is an unusual finding in myopic patients.1 While increased choroidal thickness documented with spectral-domain optical coherence tomography (SD-OCT) is a hallmark of CSC in emmetropes,2 it has not been described in myopes, who are known to have thinner choroids.3 The aim of this study is to investigate choroidal thickness in these patients.
Methods: :
Imaging analysis of patients diagnosed with CSC and moderate to high myopia. The diagnosis of CSC was confirmed by clinical examination, fluorescein and indocyanine green angiography, fundus autofluorescence imaging and SD-OCT (Spectralis™, Heidelberg Engineering Inc., Heidelberg, Germany). Choroidal thickness was measured subfoveally with digital calipers using enhanced depth imaging (EDI) SD-OCT.
Results: :
Seven eyes of 7 patients (5 male; 2 female) with a mean age ± standard deviation (SD) of 41.9 ± 10.8 years (range, 29 to 53 years) were included. The mean refractive error ± SD was -5.8 ± 2.6 diopters (range, -3.0 to -9.0 diopters). Mean Snellen visual acuity was 20/30 (range, 20/20 to 20/60). All patients showed evidence of subretinal fluid and/or pigment epithelial detachment on SD-OCT imaging. The mean subfoveal choroidal thickness ± SD measured 317.8 ± 102.9 µm (range, 215 to >500µm). Subfoveal choroidal thickness in all but 1 patient in our study would have been considered "normal" in emmetropes (mean 287µm, SD ± 76µm).4 Age, refractive error, and visual acuity did not correlate with choroidal thickness in our study group.
Conclusions: :
While CSC in myopia is relatively uncommon, these eyes appear to have an increased choroidal thickness relative to normal eyes with similar degrees of myopia. When evaluating myopic patients with suspected CSC, awareness of normal EDI-OCT choroidal thickness values in eyes with similar degrees of myopia is important for the correct interpretation of the results.1 Wang S, Wen F, Dai Z. [The state of diopter and visual acuity in central serous chorioretinopathy]. Yan Ke Xue Bao. 2002 Dec;18(4):214-6.2Imamura Y, Fujiwara T, Margolis R, Spaide RF. Enhanced depth imaging optical coherence tomography of the choroid in central serous chorioretinopathy. Retina. 2009 Nov-Dec;29(10):1469-73.3 Fujiwara T, Imamura Y, Margolis R, Slakter JS, Spaide RF. Enhanced depth imaging optical coherence tomography of the choroid in highly myopic eyes. Am J Ophthalmol. 2009 Sep;148(3):445-50.4 Margolis R, Spaide RF. A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes. Am J Ophthalmol. 2009 May;147(5):811-5.
Keywords: choroid • imaging/image analysis: clinical • myopia