Choroidal circulation time by wide-field indocyanine green angiography in central serous chorioretinopathy

Asymmetric dilated vortex veins (ADVV) extending continuously to the vortex ampullae seen on Indocyanine green angiography (ICGA) findings, are thought to indicate choroidal venous congestion in central serous chorioretinopathy (CSC). In addition, the sclera is thickened compared to normal eyes, suggesting that obstruction of the scleral passage is the pathophysiological mechanism of CSC. The purpose of this study was to examine the choroidal circulation in and around the vortex vein ampulla.

Single-center retrospective study.

The subjects were 23 CSC eyes with macular central serous detachment (SRD) undergoing wide-field ICGA with Spectralis^®. Choroidal circulation time was defined as the time from the onset of filling in the choroidal artery to the first appearance of dye in the vortex vein ampulla. The choroidal circulation time in the superior and inferior vortex veins were measured separately. The relationship between the ADVV and the choroidal circulation time was investigated.

The mean choroidal circulation time was 4.44 seconds for the superior temporal side and 4.33 seconds for the inferior temporal side, with no significant difference (p=0.494). The mean choroidal circulation time was 3.89 seconds on the ADVV side and 4.88 seconds on the non-ADVV side, with a shorter mean circulation time on the ADVV side (p=0.00005). In 21 of 23 eyes, there was a time difference in the filling of the choroidal veins entering the vortex vein ampulla.

On the side of the ADVV, no obstruction to the passage of the sclera is thought to have occurred.