Improved thickness measurement method for choroidal hyperpermeability in central serous chorioretinopathy

Area of Science:

• Ophthalmology
• Retinal diseases
• Medical imaging

Background:

• Central serous chorioretinopathy (CSC) is a condition characterized by fluid accumulation under the retina.
• Photodynamic therapy (PDT) is a treatment option for CSC, but its precise effects on choroidal changes require further investigation.
• Indocyanine green angiography (ICGA) and optical coherence tomography (OCT) are key imaging modalities for visualizing choroidal vasculature and retinal layers.

Purpose of the Study:

• To evaluate choroidal thickness changes in the choroidal hyperpermeability area (CHA) in CSC patients post-PDT.
• To compare the effectiveness of monitoring CHA versus central choroidal thickness for treatment assessment.
• To investigate the impact of CHA location relative to the fovea on treatment outcomes.

Main Methods:

• A cohort study involving 17 CSC patients treated with half-dose verteporfin PDT.
• Patients were categorized into two groups based on whether the CHA, identified by ICGA, involved the fovea.
• Choroidal thickness, best-corrected visual acuity (BCVA), and subretinal fluid (SRF) were measured using OCT before and at 1 and 3 months after PDT.

Main Results:

• Significant reduction in central choroidal thickness was observed in patients with foveal involvement (Group A) and overall.
• Choroidal hyperpermeability area (CHA) thickness and BCVA showed significant improvements in both groups and overall.
• Complete SRF absorption was achieved in all patients by 3 months post-PDT.

Conclusions:

• Central choroidal thickness may not be a reliable indicator of treatment response in CSC patients when the CHA does not involve the fovea.
• Monitoring changes within the CHA itself offers a more comprehensive and less biased assessment of PDT efficacy in CSC.
• CHA-focused monitoring can improve the understanding and management of CSC, particularly in cases without foveal engagement.