Abstract
Abstract: :
Purpose: choroidal hyperfluorescence on indocyanine green angiography due to choroidal hyperpermeability has been reported in patients with central serous chorioretinopathy (CSCR).The aim of this study was to investigate whether a novel ultrasound technique could detect choroidal layer abnormalities in eyes with CSCR. Methods: in both eyes of five consecutive patients (mean age 37 ± 4 years) with unilateral acute idiopathic CSCR and ten age–matched controls B–scan ultrasonography with a 20 MHz immersion probe was performed at similar gain setting. The axial resolution of the ultrasound unit (Cinescan S, Quantel Medical) was 100 around micron; horizontal axial scans of the macula were directly acquired into a PC. Indocyanine and fluorescein angiography revealed typical findings in three male patients with CSCR and could not be performed in the two pregnant women with CSCR. Inclusion criteria prior to ultrasound examination in all eyes with CSCR were macular neurosensory detachment on optical coherent tomography (OCT) examination and normal OCT results in fellow and control eyes. Another series of five eyes of five patients with OCT – proven cystoid macular edema (CME) underwent ultrasound examination with the same technique. Results: on ultrasound examination in all five eyes with CSCR a dome–shaped macular detachment could be appreciated , and – under the high reflective retinal pigment epithelium – a non echogenic linear band akin to the echofree space between the elevated neurosensory retina and the retinal pigment epithelium. Choroidal extravasal fluid accumulation seems a reasonable explanation of the subretinal thick line that could not be found in fellow eyes, in ten control eyes and in five eyes with CME, where macular elevation could be echographically evidenced. Conclusion: in eyes with acute CSCR high frequency ultrasound imaging can detect retinal elevation associated with a non echogenic linear band which appears consistent with the hyperpermeability of choroidal capillaries leading to retinal neurosensory detachment. Although fluorescein and indocyanine green angiography and OCT are the gold standard for the diagnosis of CSCR, ultrasonography may add further evidence on pathogenesis of CSCR and might be useful when conventional diagnostic exams cannot be performed.
Keywords: macula/fovea • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • choroid