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Published on: August 11, 2023
Association between Choroidal Vascular Hyperpermeability and Vortex Vein Anastomoses in Central Serous
Yasunori Miyara1, Nobuhiro Terao1, Naoya Imanaga1
1Department of Ophthalmology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
Purpose:
To investigate the association between choroidal vascular hyperpermeability (CVH) and vortex vein anastomoses in the macula of patients with central serous chorioretinopathy (CSC).
Design:
A retrospective comparative study.
Subjects:
A total of 118 eyes of 106 patients with CSC.
Methods:
All patients underwent choroidal en face imaging using widefield swept-source OCT. The eyes were classified into watershed zone (WZ) and non-WZ groups. The horizontal WZ through the macula was identified in the WZ group, whereas it was ill-defined in the non-WZ group, because of marked anastomoses between the superior and inferior vortex veins. The number and distribution of CVH areas, as detected on indocyanine green angiography, were evaluated and compared between the 2 groups.
Main Outcome Measures:
Association between CVH and vortex vein anastomoses in CSC.
Results:
Overall, 118 eyes were classified into the WZ (n = 81) and non-WZ (n = 37) groups. The mean number of CVH areas per eye was significantly higher in the non-WZ group than in the WZ group (4.95 vs. 2.43; P < 0.001). In both groups, almost half of the CVH areas were located in proximity to the boundary between the superior and inferior vortex veins. However, CVH areas outside the retinal vascular arcade were more frequently observed in the non-WZ group than in the WZ group (31.1% vs. 18.8%; P = 0.002). Among 95 eyes with asymmetric vortex veins, CVH areas on the nondominant vortex vein side were more frequently observed in the non-WZ group than in the WZ group (29.7% vs. 18.1%; P < 0.001).
Conclusions:
Central serous chorioretinopathy eyes with an ill-defined WZ due to marked vortex vein anastomoses had more multifocal and extensive CVH areas than those with an identified WZ. The presence of vortex vein anastomoses may affect the number and distribution of CVH areas in eyes with CSC.
Financial Disclosures:
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
