The characteristics of optical coherence tomography angiography on choroidal vessels in eyes of unilateral acute central serous chorioretinopathy_Chinese Journal of Ocular Fundus Diseases

Authors：

Hou Junjun ¹ ,  Chen Song ¹ , Wang Xiaogang ² , Wu Bin ¹ , He Guanghui ¹ , Wang Jian ¹ , Yang Jihong ²

1. Clinical College of Ophthalmology of Tianjin Medical University, Tianjin Eye Hospital, Tianjin Key lab of Ophthalmology and Visual Science, Tianjin Institute of Ophthalmology, Tianjin 300020, China;
2. Shanxi Eye Hospital, Taiyuan 030002, China Hou Junjun is working on the Shanxi Eye Hospital, Taiyuan 030002, China;

Corresponding author：

Chen Song, Email: chensong9999@126.com

Keywords：

Central serous chorioretinopathy; Tomography, optical coherence; Diagnostic imaging

DOI：

10.3760/cma.j.issn.1005-1015.2019.01.011

Video：

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ObjectiveTo observe the changes of macular structure and choroidal capillary blood flow density in patients with acute central serous chorioretinopathy (CSC).MethodsProspective cross-sectional study. A total of 24 eyes of 24 patients with monocular acute CSC (case group) diagnosed by clinical examination from Shanxi Eye Hospital during January and March 2018 were included in the study. The eyes (24 eyes) and contralateral eyes (24 eyes) of the patients in the case group were set to CSC group and contralateral eye group, respectively. Twenty-one eyes of 21 healthy volunteers with age and gender matching were selected as normal control group. The macular structure of the eyes were observed by OCT and OCT angiography (OCTA), and the blood vessel density of choroidal capillary layer in the circular area of the macular area with a radius of 1 mm was measured. The paired t-test was used to compare the differences in blood flow density in the choroidal capillaries between the three groups.ResultsThe results of OCT showed that the serous neuroepithelial detachment in the macular area was observed in all eyes of the CSC group, with or without RPE detachment being 20 or 4 eyes, respectively. Of the 24 eyes in the contralateral eye group, 13 eyes (54.2%) had thick choroidal RPE lesions (PPE). There was no abnormality in the retina and choroidal structure in the macular area of the normal control group. The results of OCTA showed that the blood flow density of choroidal capillaries in the CSC group, the contralateral eye group and the normal control group were 1.759±0.132, 1.924±0.463, and 1.940±0.033, respectively. Compared with the eyes of the contralateral eye group and the normal control group, the blood flow density of choroidal capillaries in the CSC group was significantly lower (t=6.611, 6.474; P=0.000, 0.000). There was no significant difference in the blood flow density of choroidal capillary layer between the contralateral eye group and the normal control group (t=1.328, P＞0.05). In the contralateral eye group, there was no significant difference in the blood flow density of choroidal capillary layer between PPE eyes and no RPE eyes (t=0.806, P＞0.05).ConclusionsThere is 54.2% of the contralateral eyes in the monocular acute CSC patients with PPE. The choroidal capillary layer blood flow density is lower than that of the contralateral and normal eyes.

Citation： Hou Junjun, Chen Song, Wang Xiaogang, Wu Bin, He Guanghui, Wang Jian, Yang Jihong. The characteristics of optical coherence tomography angiography on choroidal vessels in eyes of unilateral acute central serous chorioretinopathy. Chinese Journal of Ocular Fundus Diseases, 2019, 35(1): 50-53. doi: 10.3760/cma.j.issn.1005-1015.2019.01.011 Copy

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2.	Imamura Y, Fujiwara T, Margolis R, et al. Enhanced depth imaging optical coherence tomography of the choroid in central serous chorioretinopathy[J]. Retina, 2009, 29(10): 1469-1473. DOI: 10.1097/IAE.0b013e3181be0a83.
3.	Maruko I, Iida T, Sugano Y, et al. Subfoveal choroidal thickness in fellow eyes of patients with central serous chorioretinopathy[J]. Retina, 2011, 31(8): 1603-1608. DOI: 10.1097/IAE.0b013e31820f4b39.
4.	Yang L, Jonas JB, Wei W. Choroidal vessel diameter in central serous chorioretinopathy[J]. Acta Ophthalmol, 2013, 91(5): 358-362. DOI: 10.1111/aos.12059.
5.	Wang M, Munch IC, Hasler PW, et al. Central serous chorioretinopathy[J]. Acta Ophthalmol, 2008, 86(2): 126-145. DOI: 10.1111/j.1600-0420.2007.00889.x.
6.	Warrow DJ, Hoang QV, Freund KB. Pachychoroid pigment epitheliopathy[J]. Retina, 2013, 33(8): 1659-1672. DOI: 10.1097/IAE.0b013e3182953df4.
7.	Dansingani KK, Balaratnasingam C, Naysan J, et al. En face imaging of pachychoroid spectrum disorders with swept-source optical coherence tomography[J]. Retina, 2016, 36(3): 499-516. DOI: 10.1097/IAE.0000000000000742.
8.	Dansingani KK, Balaratnasingam C, Klufas MA, et al. Optical coherence tomography angiography of shallow irregular pigment epithelial detachments in pachychoroid spectrum disease[J]. Am J Ophthalmol, 2015, 160(6): 1243-1254. DOI: 10.1016/j.ajo.2015.08.028.
9.	Chung YR, Kim JW, Kim SW, et al. Choroidal thickness in patients with central serous chorioretinopathy: assessment of Haller and Sattler Layers[J]. Retina, 2016, 36(9): 1652-1657. DOI: 10.1097/IAE.0000000000000998.
10.	Yannuzzi NA, Mrejen S, Capuano V, et al. A central hyporeflective subretinal lucency correlates with a region of focal leakage on fluorescein angiography in eyes with central serous chorioretinopathy[J]. Ophthalmic Surg Lasers Imaging Retina, 2015, 46(8): 832-836. DOI: 10.3928/23258160-20150909-07.
11.	Prünte C, Flammer J. Choroidal capillary and venous congestion in central serous chorioretinopathy[J]. Am J Ophthalmol, 1996, 121(1): 26-34. DOI: 10.1016/S0002-9394(14)70531-8.
12.	Kitaya N, Nagaoka T, Hikichi T, et al. Features of abnormal choroidal circulation in central serous chorioretinopathy[J]. Br J Ophthalmol, 2003, 87: 709-712. DOI: 10.1136/bjo.87.6.709.
13.	Tittl M, Polska E, Kircher K, et al. Topical fundus pulsation measurement in patients with active central serous chorioretinopathy[J]. Arch Ophthalmol, 2003, 121: 975-978. DOI: 10.1001/archopht.121.7.975.
14.	Gal-Or O, Dansingani KK, Sebrow D, et al. Inner choroidal flow signal attenuation in pachychoroid disease: optical coherence tomography angiography[J]. Retina, 2018, 38(10): 1984-1992. DOI: 10.1097/IAE.0000000000002051.
15.	郭敬丽, 丁心怡, 邬海翔, 等. 急性中心性浆液性脉络膜视网膜病变患眼光相干断层扫描血管成像观察[J]. 中华眼底病杂志, 2017, 33(5): 494-497. DOI: 10.3760/cma.j.issn.1005-1015.2017.05.013.Guo JL, Ding XY, Wu HX, et al. The features of optical coherence tomography angiography in acute central serous chorioretinopathy eyes[J]. Chin J Ocul Fundus Dis, 2017, 33(5): 494-497. DOI: 10.3760/cma.j.issn.1005-1015.2017.05.013.
16.	Pang CE, Freund KB. Pachychoroid neovasculopathy[J]. Retina, 2015, 35(1): 1-9. DOI: 10.1097/IAE.0000000000000331.
17.	Ersoz MG, Arf S, Hocaoglu M, et al. indocyanine green angiography of pachychoroid pigment epitheliopathy[J]. Retina, 2018, 38(9): 1668-1674. DOI: 10.1097/IAE.0000000000001773.
18.	Ersoz MG, Karacorlu M, Arf S, et al. Pachychoroid pigment epitheliopathy in fellow eyes of patients with unilateral central serous chorioretinopathy[J]. Br J Ophthalmol, 2018, 102(4): 473-478. DOI: 10.1136/bjophthalmol-2017-310724.
19.	Zhang F, Qiu Y, Stewart JM. A case of relapsing retinal pigment epithelial detachment in peripapillary pachychoroid pigment epitheliopathy[J]. Retin Cases Brief Rep, 2018, 12 Suppl 1: S110-113. DOI: 10.1097/ICB.0000000000000658.

1. Daruich A, Matet A, Dirani A, et al. Central serous chorioretinopathy: recent findings and new physiopathology hypothesis[J]. Prog Retin Eye Res, 2015, 48: 82-118. DOI: 10.1016/j.preteyeres.2015.05.003.
2. Imamura Y, Fujiwara T, Margolis R, et al. Enhanced depth imaging optical coherence tomography of the choroid in central serous chorioretinopathy[J]. Retina, 2009, 29(10): 1469-1473. DOI: 10.1097/IAE.0b013e3181be0a83.
3. Maruko I, Iida T, Sugano Y, et al. Subfoveal choroidal thickness in fellow eyes of patients with central serous chorioretinopathy[J]. Retina, 2011, 31(8): 1603-1608. DOI: 10.1097/IAE.0b013e31820f4b39.
4. Yang L, Jonas JB, Wei W. Choroidal vessel diameter in central serous chorioretinopathy[J]. Acta Ophthalmol, 2013, 91(5): 358-362. DOI: 10.1111/aos.12059.
5. Wang M, Munch IC, Hasler PW, et al. Central serous chorioretinopathy[J]. Acta Ophthalmol, 2008, 86(2): 126-145. DOI: 10.1111/j.1600-0420.2007.00889.x.
6. Warrow DJ, Hoang QV, Freund KB. Pachychoroid pigment epitheliopathy[J]. Retina, 2013, 33(8): 1659-1672. DOI: 10.1097/IAE.0b013e3182953df4.
7. Dansingani KK, Balaratnasingam C, Naysan J, et al. En face imaging of pachychoroid spectrum disorders with swept-source optical coherence tomography[J]. Retina, 2016, 36(3): 499-516. DOI: 10.1097/IAE.0000000000000742.
8. Dansingani KK, Balaratnasingam C, Klufas MA, et al. Optical coherence tomography angiography of shallow irregular pigment epithelial detachments in pachychoroid spectrum disease[J]. Am J Ophthalmol, 2015, 160(6): 1243-1254. DOI: 10.1016/j.ajo.2015.08.028.
9. Chung YR, Kim JW, Kim SW, et al. Choroidal thickness in patients with central serous chorioretinopathy: assessment of Haller and Sattler Layers[J]. Retina, 2016, 36(9): 1652-1657. DOI: 10.1097/IAE.0000000000000998.
10. Yannuzzi NA, Mrejen S, Capuano V, et al. A central hyporeflective subretinal lucency correlates with a region of focal leakage on fluorescein angiography in eyes with central serous chorioretinopathy[J]. Ophthalmic Surg Lasers Imaging Retina, 2015, 46(8): 832-836. DOI: 10.3928/23258160-20150909-07.
11. Prünte C, Flammer J. Choroidal capillary and venous congestion in central serous chorioretinopathy[J]. Am J Ophthalmol, 1996, 121(1): 26-34. DOI: 10.1016/S0002-9394(14)70531-8.
12. Kitaya N, Nagaoka T, Hikichi T, et al. Features of abnormal choroidal circulation in central serous chorioretinopathy[J]. Br J Ophthalmol, 2003, 87: 709-712. DOI: 10.1136/bjo.87.6.709.
13. Tittl M, Polska E, Kircher K, et al. Topical fundus pulsation measurement in patients with active central serous chorioretinopathy[J]. Arch Ophthalmol, 2003, 121: 975-978. DOI: 10.1001/archopht.121.7.975.
14. Gal-Or O, Dansingani KK, Sebrow D, et al. Inner choroidal flow signal attenuation in pachychoroid disease: optical coherence tomography angiography[J]. Retina, 2018, 38(10): 1984-1992. DOI: 10.1097/IAE.0000000000002051.
15. 郭敬丽, 丁心怡, 邬海翔, 等. 急性中心性浆液性脉络膜视网膜病变患眼光相干断层扫描血管成像观察[J]. 中华眼底病杂志, 2017, 33(5): 494-497. DOI: 10.3760/cma.j.issn.1005-1015.2017.05.013.Guo JL, Ding XY, Wu HX, et al. The features of optical coherence tomography angiography in acute central serous chorioretinopathy eyes[J]. Chin J Ocul Fundus Dis, 2017, 33(5): 494-497. DOI: 10.3760/cma.j.issn.1005-1015.2017.05.013.
16. Pang CE, Freund KB. Pachychoroid neovasculopathy[J]. Retina, 2015, 35(1): 1-9. DOI: 10.1097/IAE.0000000000000331.
17. Ersoz MG, Arf S, Hocaoglu M, et al. indocyanine green angiography of pachychoroid pigment epitheliopathy[J]. Retina, 2018, 38(9): 1668-1674. DOI: 10.1097/IAE.0000000000001773.
18. Ersoz MG, Karacorlu M, Arf S, et al. Pachychoroid pigment epitheliopathy in fellow eyes of patients with unilateral central serous chorioretinopathy[J]. Br J Ophthalmol, 2018, 102(4): 473-478. DOI: 10.1136/bjophthalmol-2017-310724.
19. Zhang F, Qiu Y, Stewart JM. A case of relapsing retinal pigment epithelial detachment in peripapillary pachychoroid pigment epitheliopathy[J]. Retin Cases Brief Rep, 2018, 12 Suppl 1: S110-113. DOI: 10.1097/ICB.0000000000000658.

Chinese Journal of Ocular Fundus Diseases

The characteristics of optical coherence tomography angiography on choroidal vessels in eyes of unilateral acute central serous chorioretinopathy

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