Evaluation of Choroidal Layer Thickness in Central Serous Chorioretinopathy

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Abstract

Purpose:

To evaluate medium and large choroidal vessel layer thickness (MCVT and LCVT, respectively) in eyes with acute and chronic central serous chorioretinopathy (CSC) in comparison with age-matched controls.

Methods:

The study included 96 eyes of 96 patients with CSC, including 53 eyes with acute CSC, 43 eyes with chronic CSC, and 30 eyes of 30 age-matched normal subjects. Manual measurements of subfoveal choroidal thickness (SFCT), MCVT, and LCVT at subfoveal and 750 μm nasal and temporal to the fovea locations were made on enhanced depth imaging optical coherence tomography (EDI-OCT) of the macula in all subjects using ImageJ software (National Institutes of Health, Bethesda, MD, USA).

Results:

SFCT in acute CSC was significantly larger than that in healthy eyes ( P = 0.0001). SFCT in acute CSC did not differ significantly from that in chronic CSC eyes. Subfoveal LCVT and MCVT in acute CSC eyes were greater than those in healthy eyes ( P = 0.02 and P = 0.03, respectively). Mean SFCT and MCVT in chronic CSC eyes were significantly larger than those in control eyes ( P = 0.01 and P = 0.04, respectively). No significant difference in LCVT was observed between chronic and control eyes.

Conclusion:

Choroidal vasculature is altered in both acute and chronic CSC. SFCT, MCVT, and LCVT are higher in eyes with acute CSC. The thickening of medium choroidal vessels is still detectable in chronic CSC compared to control eyes.

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Most cited references 23

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Central serous chorioretinopathy: Recent findings and new physiopathology hypothesis.

Alejandra Daruich, Alexandre Matet, Ali Dirani … (2015)

Central serous chorioretinopathy (CSCR) is a major cause of vision threat among middle-aged male individuals. Multimodal imaging led to the description of a wide range of CSCR manifestations, and highlighted the contribution of the choroid and pigment epithelium in CSCR pathogenesis. However, the exact molecular mechanisms of CSCR have remained uncertain. The aim of this review is to recapitulate the clinical understanding of CSCR, with an emphasis on the most recent findings on epidemiology, risk factors, clinical and imaging diagnosis, and treatments options. It also gives an overview of the novel mineralocorticoid pathway hypothesis, from animal data to clinical evidences of the biological efficacy of oral mineralocorticoid antagonists in acute and chronic CSCR patients. In rodents, activation of the mineralocorticoid pathway in ocular cells either by intravitreous injection of its specific ligand, aldosterone, or by over-expression of the receptor specifically in the vascular endothelium, induced ocular phenotypes carrying many features of acute CSCR. Molecular mechanisms include expression of the calcium-dependent potassium channel (KCa2.3) in the endothelium of choroidal vessels, inducing subsequent vasodilation. Inappropriate or over-activation of the mineralocorticoid receptor in ocular cells and other tissues (such as brain, vessels) could link CSCR with the known co-morbidities observed in CSCR patients, including hypertension, coronary disease and psychological stress.

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Enhanced depth imaging optical coherence tomography of the choroid in central serous chorioretinopathy.

Yutaka Imamura, Takamitsu Fujiwara, Ron Margolis … (2009)

The purpose of the study was to evaluate the choroidal thickness in patients with central serous chorioretinopathy, a disease attributed to increased choroidal vascular hyperpermeability. Patients with central serous chorioretinopathy underwent enhanced depth imaging spectral-domain optical coherence tomography, which was obtained by positioning a spectral-domain optical coherence tomography device close enough to the eye to acquire an inverted image. Seven sections, each comprising 100 averaged scans, were obtained within a 5 degrees x 30 degrees rectangle to encompass the macula. The subfoveal choroidal thickness was measured from the outer border of the retinal pigment epithelium to the inner scleral border. The mean age of subjects undergoing enhanced depth imaging spectral-domain optical coherence tomography was 59.3 years (standard deviation, 15.8 years). Seventeen of 19 patients (89.5%) were men, and 12 (63.2%) patients had bilateral clinical disease. The choroidal thickness measured in 28 eligible eyes of the 19 patients was 505 microm (standard deviation, 124 microm), which was significantly greater than the choroidal thickness in normal eyes (P < or = 0.001). Enhanced depth imaging spectral-domain optical coherence tomography demonstrated a very thick choroid in patients with central serous chorioretinopathy. This finding provides additional evidence that central serous chorioretinopathy may be caused by increased hydrostatic pressure in the choroid.

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Choroidal thickness in polypoidal choroidal vasculopathy and exudative age-related macular degeneration.

Song Chung, Se Kang, Jung Lee … (2011)

To compare choroidal thickness between eyes with polypoidal choroidal vasculopathy (PCV) and eyes with age-related macular degeneration (AMD). Observational, comparative case series. Twenty-five eyes with PCV, 14 uninvolved fellow eyes with PCV, 30 eyes with exudative AMD, 17 eyes with early AMD, and 20 eyes of age-matched normal subjects. Choroidal thickness was measured using enhanced-depth imaging optical coherence tomography. Subfoveal choroidal thickness in each eye was analyzed by measurement of the vertical distance from the Bruch's membrane to the innermost scleral layer. Nasal, superior, temporal, and inferior choroidal thicknesses, 1500 μm apart from the foveal center, were also evaluated in all eyes. Choroidal thickness in each group. Mean (± standard deviation) subfoveal choroidal thickness in eyes with PCV and in their uninvolved fellow eyes was 438.3±87.8 μm and 372.9±112.0 μm, respectively, which was significantly greater than in eyes of age-matched normal subjects (224.8±52.9 μm) (P<0.001 and P = 0.003, respectively). Subfoveal choroidal thickness of eyes with exudative AMD (171.2±38.5 μm) and eyes with early AMD (177.4±49.7 μm) was thinner than that of age-matched normal subjects (P = 0.004 and P = 0.078, respectively). Choroidal thickness at each of the other 4 points showed a similar tendency. This study demonstrates thickening of choroid in the eyes with PCV, in contrast with choroidal thinning observed in eyes with AMD. These findings suggest involvement of different pathogenic mechanisms in PCV from those in exudative AMD. Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

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Author and article information

Journal

Journal ID (nlm-ta): J Ophthalmic Vis Res

Journal ID (iso-abbrev): J Ophthalmic Vis Res

Journal ID (publisher-id): JOVR

Title: Journal of Ophthalmic & Vision Research

Publisher: Wolters Kluwer - Medknow (India )

ISSN (Print): 2008-2010

ISSN (Electronic): 2008-322X

Publication date (Print): Apr-Jun 2019

Volume: 14

Issue: 2

Pages: 164-170

Affiliations

[1 ] Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom

[2 ] Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands

[3 ] Srimati Kanuri Santhamma Centre for Vitreo-Retinal Diseases, Hyderabad Eye Research Foundation, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, Telangana, India

[4 ] Department of Ophthalmology, Giridhar Eye Institute, Kochi, Kerala, India

[5 ] Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA

[6 ] Banker's Retina Clinic and Laser Centre, 5 Subhash Society, Ahmedabad, Gujarat, India

[7 ] Asociados de Mácula Vitreo y Retina de Costa Rica, Apdo 144-1225 Plaza Mayor, San Jose, Costa Rica

Author notes

Correspondence to: Jay Chhablani. Srimati Kanuri Santhamma Centre for Vitreo-Retinal Diseases, Hyderabad Eye Research Foundation, Kallam Anji Reddy campus, L V Prasad Eye Institute, Hyderabad 500034, India. E-mail: jay.chhablani@ 123456gmail.com

Author information

Daren Hanumunthadu http://orcid.org/0000-0002-2926-8460

Jay Chhablani http://orcid.org/0000-0003-1772-3558

Article

Publisher ID: JOVR-14-164

DOI: 10.4103/jovr.jovr_152_17

PMC ID: 6504723

PubMed ID: 31114653

SO-VID: 19d021ba-8bd6-4fa5-8d69-8d0d135b1c15

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This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Evaluation of Choroidal Layer Thickness in Central Serous Chorioretinopathy

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Karger: Ophthalmology

Most cited references 23

Central serous chorioretinopathy: Recent findings and new physiopathology hypothesis.

Enhanced depth imaging optical coherence tomography of the choroid in central serous chorioretinopathy.

Choroidal thickness in polypoidal choroidal vasculopathy and exudative age-related macular degeneration.

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