Choroidal Angiographic Feature Associated with Persistent Subretinal Fluid in Central Serous Chorioretinopathy

Abstract

Purpose : The subretinal fluid (SRF) associated with central serous chorioretinopathy (CSC) can spontaneously resolve within a few months. However, the SRF can recur or persist, impairing visual function. Recent developments in optical coherence tomography (OCT), especially enhanced depth imaging (EDI) and swept-light source (SS), have facilitated the evaluation of choroidal vasculature. This evaluation suggests that congestive flow in the vortex veins might be involved in CSC development. However, the wide field (WF) choroidal vasculature associated with the CSC-SRF has not been fully elucidated. We analyzed the EDI of WF SS-OCT data of the choroid of eyes with CSC and examined the choroidal angiographic features in the posterior pole that could predict the resolution or prolongation of the SRF.

Methods : We included twenty-nine patients with treatment-naïve CSC, and observed for more than three months without treatment. Using EDI of WF SS-OCT (Xephilio OCT-S1, Canon Inc.), the choroidal thickness (CT), vessel density (VD), vessel length density (VLD), and vessel diameter index (VDI) in the superotemporal and inferotemporal subfields of the 18-mm-diameter circle centered on the fovea were measured at the initial visit. The patients were divided into two groups based on the presence (SRF-persistent group) or absence (SRF-resolved group) of SRF three months after the initial visit (Month 3). We calculated the vertical differences in CT and other choroidal angiographic parameters and evaluated their association with the SRF condition at Month 3.

Results : The SRF-resolved and SRF-persistent groups included 10 and 19 patients, respectively. At the initial visit, sex, age, axial length, symptom duration, logarithm of minimum angle of resolution visual acuity, and retinal thickness at the fovea were not different between the two groups. No significant association was observed between SRF status at Month 3 and the vertical differences in CT, choroidal VD, and VLD (P = 0.534, 0.094, 0.092, respectively). However, the vertical difference in choroidal VDI was positively associated with SRF presence (P < 0.001).

Conclusions : In eyes with CSC, dilated choroidal vessels in the posterior pole may be a biomarker associated with SRF; the vertically asymmetrical choroidal dilation may be a good predictor of SRF-status.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.