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C. Nischler, K. Weikinger, C. Wintersteller, G. Grabner, H. A. Reitsamer; Flicker Response of Retinal Vessels Changes in Patients With Active Central Serous Chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2009;50(13):766.
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Central serous chorioretinopathy (CSC), a frequently occurring retinal disease that predominantly affects young to middle-aged men, has been known since 1866, but its exact pathogenesis still remains obscure. On the basis of our current understanding of the disorder, a multifactorial concept has evolved, involving several risk factors such as age, race, gender, blood pressure, corticosteroids, certain systemic conditions and type-A personality. In this study patients with CSC were investigated as to whether they differ in retinal vascular functions.
In this prospective case-controlled study retinal vessels of 22 patients (20 male and 2 female) with active CSC were analysed with the "DVA/DVA Plus Dynamic Vessel Analyzer" (Imedos, Germany) and data were compared to a control group of an age and gender-matched internal database. In addition blood pressure measurement, a complete ophthalmic examination including intraocular pressure and optical coherence tomography were performed.
Intraocular pressure and blood pressure of patients were within a normal range. Patients with active CSC did not differ significantly form control group in static parameters of retinal vessel analysis (arterial-venous quotient), but did differ significantly in all dynamic parameters. The maximum of arterial constriction (-0.3% [CI95%: -0.8 to 0.2%]) and dilatation (+3.2% [CI95%: 2.2 to 4.2%]) and the maximum of venous dilatation (+3.0% [CI95%: 2.3 to 3.7%]) in patients with CSC were all significantly lower than in the control group (p<0.05).
To date choroidal hemodynamic changes have been shown in several studies to play a role in the pathogenesis of CSC. In addition to these reports our data indicate that also retinal vascular dysregulation seems to be involved in CSC. Vascular autoregulation is a crucial factor in the integrity of the peripheral circulation and may be altered by previous mentioned risk factors of CSC.
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