Choroidal blood flow changes in central serous chorioretinopathy

Area of Science:

• Ophthalmology
• Retinal Diseases
• Choroidal Circulation

Background:

• Central serous chorioretinopathy (CSC) is characterized by fluid accumulation under the retina.
• The role of choroidal blood flow alterations in the development of pigment epithelial detachment (PED) and subretinal fluid (SRF) in CSC remains incompletely understood.

Purpose of the Study:

• To investigate the relationship between choroidal blood flow parameters and the presence of PED and SRF in patients with CSC.
• To compare choroidal vascularity and thickness between CSC patients and healthy controls.

Main Methods:

• Swept-source optical coherence tomography (SS-OCT) was used to assess choroidal vascularity and thickness.
• Quantification of three-dimensional choroidal vascular index (CVI), choroidal vascular volume (CVV), subretinal fluid (SRF) and pigment epithelial detachment (PED) area and volume.
• Analysis of flow void area (FVa) and flow void area percentage (FV%) in the choriocapillary using Image-J.

Main Results:

• CSC patients exhibited significantly higher subfoveal choroidal thickness (SFCT), CVI, CVV, FVa, and FV% compared to healthy controls.
• CSC patients with PED showed a greater three-dimensional CVI than those without PED.
• FV% positively correlated with SRF area, CVV, and SFCT in CSC patients. In the PED group, CVV correlated with PED-ct, FVa, FV%, and both PED and SRF area.

Conclusions:

• The presence of PED and SRF in CSC is associated with increased choroidal vascular density and thickness, alongside altered choriocapillary blood flow.
• These findings suggest a complex interplay between vascular changes in the Sattler and Haller layers and the pathogenesis of PED and SRF in CSC.