Abstract
Purpose :
To investigate by optical coherence tomography angiography (OCT-A) the chorioretinal vascular response to experimentally increased blood pressure in patients with central serous chorioretinopathy (CSCR).
Methods :
Multicenter, prospective, observational, case-control study including thirty-five eyes of 35 patients with an established diagnose of CSCR and 25 eyes of 25 age-matched healthy controls. All subjects underwent a hand-grip isometric exercise for three minutes. In the resting phase and during the physical effort macular OCT-A volume scans were acquired using the Spectralis OCT-A, based on a full-spectrum amplitude-decorrelation algorithm. Systemic hemodynamic data were recorded at baseline and during stress conditions using an electronic sphygmomanometer. On OCT-angiograms qualitative and quantitative assessments of the retinal superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris (CC) were performed. The results obtained in CSCR patients were compared with those of healthy subjects. The under-stress perfusion behavior of choroidal neovascularizations (CNV) complicating some CSCR cases was also evaluated.
Results :
Baseline and under stress data of SBP, DBP, MAP and OPP were significantly higher (p<0.05) in CSCR patients compared to controls, reaching values in the range of hypertension. Baseline VD values of SCP, DCP and CC were significantly lower (p<0.05) in CSCR cases compared to healthy subjects. A significant increase (p<0.05) of the same values under stress condition was noticed in CSCR patients and not noticed in controls. The qualitative analysis of OCT-angiograms evidenced microcirculatory changes during exercise only in CSCR patients. A type I CNV was detected in 5 eyes with CSCR and resulted to be better outlined on the OCT-angiograms taken during the hemodynamic stress.
Conclusions :
Results of the present study suggest that retinal and choroidal blood flow is disregulated in CSCR. During physical stress patients with this disease easily reach critical values of blood pressure that are not dampened by regulatory mechanisms in choroidal and retinal vessels. The choroid in CSCR could be particularly vulnerable to variations of systemic hemodynamics.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.