Purpose:
Choroidal vascular pathologies such as venous dilation and hyper-permeability are causative for central serous chorioretinopathy (CSC). In order to investigate the choroidal morphological changes, we measured choroidal thickness in CSC by high-penetration OCT (HP-OCT), and compared.Patients and
Methods:
A custom-built HP-OCT (Swept source, 50,000 A-scan/s, 1060 nm wavelength) was used to image 26 eyes of 20 patients with CSC (Average 55 years old, 12 patients unilaterally and 8 patients bilaterally). The scan protocol was 6 x 6 mm square containing 512 x 256 A-scans. Eyes with high myopia (> -6D), any other macular complications, or history of photodynamic therapy were excluded. We compared following parameters: (1) subfoveal choroidal thickness in affected eyes to that in fellow eyes in unilateral CSC defined by the presence of fluorescein leakage, (2) choroidal thickness at the position of fluorescein leakage in affected eyes to that of corresponding part in fellow eyes in unilateral patients, (3) subfoveal choroidal thickness in all cases (26 eyes) to age-matched normal database (Ikuno et al., IOVS 2009). We obtained informed consent from all participants with an IRB approval from Osaka University Hospital.
Results:
Images from unilateral CSC patient are shown in the figure (Left; normal, Right; CSC). The chorio-scleral interface was clearly visible in all eyes. (1) The average subfoveal choroidal thickness was 435µm in affected eyes and 353µm in fellow eyes (p<0.001) in unilateral cases. (2) The average choroidal thickness at the fluorescein leakage was 422µm and 334µm at the corresponding part in healthy fellow eyes (p<0.05). (3) The average subfoveal choroidal thickness was 468µm in CSC and 384µm in normal age-matched database (p<0.05).
Conclusions:
Choroid is significantly thickened in CSC. This seems to be from choroidal venous dilation and hyper-permeability, which are hallmarks of this disease.
Keywords: retina • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • choroid