Choroidal thickness measurements during central serous chorioretinopathy treatment

Abstract

To determine changes in choroidal thickness in patients with central serous chorioretinopathy (CSCR) during the first 3 months after initial diagnosis and assess variable therapeutic interventions via enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT). In this prospective study, choroidal thickness was measured via EDI-OCT both in the affected and fellow eyes of 10 patients with CSCR at the fovea, as well as at 500 and 1,000 μm both temporal and nasal from the centre of the fovea and at the leakage point (if present), visualised via fluorescein angiography. Follow-up measurements were performed after 2-3 weeks, 6-8 weeks and 3 months. Seven of the 10 patients received additional systemic therapy with oral acetazolamide. A control group of eight healthy subjects was recruited to determine normal choroidal thickness in healthy eyes. The mean age of the 10 patients (9 male, 1 female) in the CSCR group was 42.1 (±9.3) years. The choroid in the affected eyes was significantly thickened at baseline compared to fellow eyes and the eyes of healthy subjects. The choroid in the fellow eyes also revealed a slight thickening at baseline compared to normal eyes. During the 3 month follow-up period, the choroidal thickness of the affected eyes showed a highly significant decrease, but did not reach normal levels. Minor changes could also be observed in the fellow eyes but did not reach statistical significance. In patients with CSCR, the average choroidal thickness not only demonstrated a significant thickening at baseline, but also showed a marked decrease after 3 months, yet not reaching normal levels. Our data indicate that after 3 months, normalisation of choroidal thickness is not yet completed.

Subfoveal choroidal thickness as a predictor of central serous chorioretinopathy

“…CT is known to be increased in eyes with CSC. [13][14][15] It gradually decreases over the next 3 months. 13 The CT is greater in areas with leakage on FFA, and in areas with choroidal vascular hyperpermeability and punctate hyperfluorescent spots on ICGA, than in the unaffected areas.…”

“…[13][14][15] It gradually decreases over the next 3 months. 13 The CT is greater in areas with leakage on FFA, and in areas with choroidal vascular hyperpermeability and punctate hyperfluorescent spots on ICGA, than in the unaffected areas. 19 The CT, although not significantly affected by laser photocoagulation, significantly reduces after PDT and is associated with decreased choroidal vascular hyperpermeability on ICGA.…”

“…It is known that subfoveal CT is higher in the acute stage and gradually decreases during the course of CSC. 13 Unlike the duration of symptoms, which is a subjective parameter, we propose that subfoveal CT, being an objective parameter, may be an indicator of the activity of the disease. However, we cannot conclude from the small number of study eyes that CT can be used as a biomarker for the treatment of CSC.…”

“…16,17 It has been reported that the CT in CSC, which is increased at baseline, gradually decreases over the next 3 months but never reaches the normal level at the end of 1 year. 13 Thus, the change in CT in this disorder is well established. However, the role that CT may have in predicting the natural course or management of this condition is still not clear.…”

“…[1][2][3][4][5][6][7][8][9][10] By using the enhanced depth imaging-optical coherence tomography (EDI-OCT) technique introduced by Spaide et al, 11,12 it has been reported that subfoveal choroidal thickness (CT) is increased in eyes with CSC as compared with normal eyes. [13][14][15] The subfoveal choroid in the fellow eyes of patients with unilateral CSC is also thicker than normal eyes, and shows choroidal vascular hyperpermeability on angiography. 16,17 It has been reported that the CT in CSC, which is increased at baseline, gradually decreases over the next 3 months but never reaches the normal level at the end of 1 year.…”