Abstract
Purpose: :
The pathogenesis of Central Serous Chorioretinopathy (CSC) is still largely unknown. Recent angiographic studies suggest the possible involvement of choroidal vascular dysregulation in the pathogenesis of CSC. The aim of this study was to investigate choroidal blood–flow characteristics in patients with CSC during the acute phase and after recovery which could explain some of the changes in the choroidal microcirculation in these patients.
Methods: :
20 consecutive patients with acute CSC (mean age 47.0±8.5 yrs), 20 age– and sexmatched normals (mean age 48.7±11.4 yrs) and 20 otherwise normals with a history of vasospasm (mean age 39.9±11.4 yrs) underwent a hand grip test while choroidal blood flow was measured by means of Laser Doppler flowmetry (LDF). Blood pressure, heart rate and IOP were monitored. All CSC–patients had acute visual disturbances, localized neurosensory detachment and typical angiographic changes. In 10 patients with complete recovery the examinations were repeated after 3 to 6 months .
Results: :
Mean blood pressure was significantly higher in CSC patients than in normals with or without vasospasm. Furthermore, mean blood pressure increase to provocation was significantly different (increase in %: 8.0±0.9, 14.8±1.2 and 12.8±1.3). Comparing results were found for heart rate with lower values for CSC patients. Baseline flow in the LDF was significantly lower in patients and response of choroidal blood flow was significantly different in CSC patients compared to both normal groups with no significant change in the CSC group but significant changes in both normal groups (increase of 15% in non–vasospastic and decrease of 10% in the vasospastic normal group during squeeze). After recovery CSC patients showed a significant (ANOVA) change in baseline choroidal LDF parameters with decreased velocity and increased volume, but unchanged flow. Significant differences were also found during recovery.
Conclusions: :
These findings suggest that choroidal blood flow characteristics and choroidal vascular reactivity is altered during the acute phase in patients with CSC. Furthermore, systemic circulation is involved in CSC patients.
Keywords: choroid • blood supply • macula/fovea