Abstract
Purpose :
Patients with central serous chorioretinopathy (CSC) are reported to have dilated, hyper-permeable choroidal vessels with leakage into the interstitial space. The vascular component of choroidal tissue can be assessed using the choroidal vascularity index (CVI), a ratio of the luminal component of the choroid to the cross-sectional choroidal area.
The aim of this study was to test for differences in the CVI in patients with chronic (cCSC), fellow eyes and healthy controls. Patients were genotyped for single-nucleotide polymorphisms (SNPs) associated with CSC and their relationship with a patient's CVI analysed.
Methods :
Patients were included with cCSC, treatment naive, with a visual acuity of ≤79 EDTRS letters, OCT evidence of sub-foveal sub-retinal fluid, and fluorescein/ICG angiography evidence of active CSC. Age-matched controls were included. The central, foveal, EDI-OCT image was agreed upon by 2 ophthalmologists. Images were analysed in ImageJ and binarised. The central sub-foveal choroidal area was selected with a width of 1,500µm, the upper border at the retinal pigment epithelium and lower border at the choroid scleral interface. The total selected sub-foveal choroidal area, luminal area (dark pixels), stromal area (light pixels) and CVI were calculated (Fig1). cCSC patients were genotyped for risk SNPs associated with CSC. ANOVA used for statistical analysis.
Results :
106 patients with cCSC and 106 control eyes were included. There was a significant increase in the sub-foveal choroidal area in cCSC patients 2.35±0.56mm2 vs controls 1.82±0.54mm2 (p<0.0001), and in fellow eyes 2.23±0.58mm2 vs controls (p<0.0001). The CVI was reduced in cCSC patients 63.45±3.10% vs controls 65.43±2.61% (p<0.0001) and in their affected vs fellow eyes 64.55±2.90% (p<0.01). There was a significant association between CVI and the presence of the risk SNP rs2379120 at GATA5 (p<0.01) in cCSC patients after Bonferroni correction.
Conclusions :
These results suggest the sub-foveal choroidal area is increased in both eyes of patients with cCSC. The relative reduction in CVI in cCSC may suggest a persistence of vessel hyper-permeability over dilation; resulting in an increase in stromal area. Tracking a patient’s CVI and relative stromal area could be used to monitor disease. GATA5 may play a role in choroidal vascularity in cCSC.
This is a 2021 ARVO Annual Meeting abstract.