A pilot study of scleral thickness in central serous chorioretinopathy using anterior segment optical coherence tomography

Lee, Yun Ji; Lee, Yeon Jeong; Lee, Jae Yeon; Lee, Suhwan

doi:10.1038/s41598-021-85229-y

Cited by 19 publications

(14 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 33 , 47 Supporting this hypothesis is the finding of increased scleral thickness in CSC eyes compared to normal eyes that could limit both choroidal venous outflow and transscleral fluid resorption. 48 , 49 …”

Section: Discussionmentioning

confidence: 99%

Ultra-Widefield Indocyanine Green Angiography Reveals Patterns of Choroidal Venous Insufficiency Influencing Pachychoroid Disease

Bacci

Singer

et al. 2022

Invest. Ophthalmol. Vis. Sci.

View full text Add to dashboard Cite

Purpose To compare patterns of choroidal venous drainage in eyes with pachychoroid disease to those of healthy subjects using ultra-widefield indocyanine green angiography (UWF ICGA). Methods Patients with pachychoroid disease and healthy controls were recruited at two referral centers. UWF ICGA images were used to evaluate the proportion of the postequatorial fundus drained by major vortex vein systems in each quadrant and to study the incidence and topography of choroidal vascular hyperpermeability (CVH) and intervortex venous anastomoses. Widefield swept-source optical coherence tomography (SS-OCT) was used to evaluate choroidal thickness at the posterior pole in eyes with pachychoroid disease. Results Fifty-two pachychoroid eyes and 26 healthy eyes were evaluated. Eyes with pachychoroid disease showed a significant within-subject variance in the proportion of the postequatorial fundus drained by each vortex vein system (range, 4.1%–48.1%; P < 0.0001) that was not seen in controls (range, 17.3%–31.7%; P = 0.11). CVH was present in all pachychoroid disease eyes and three of 26 controls. Intervortex venous anastomoses were present in 46 of 52 pachychoroid disease eyes and nine of 26 control eyes. Vortex vein systems with large drainage areas showed greater density of CVH spots. SS-OCT demonstrated asymmetric choroidal drainage in the macula of 59% of pachychoroid eyes. CVH and intervortex venous anastomoses were more prominent in areas showing maximal choroidal thickness. Conclusions In eyes with pachychoroid disease, imbalanced choroidal venous drainage with congestion of specific vortex vein systems may contribute to a state of choroidal venous insufficiency characterized by regional choroidal thickening, CVH and remodeling of venous drainage routes.

show abstract

Section: Discussionmentioning

confidence: 99%

Ultra-Widefield Indocyanine Green Angiography Reveals Patterns of Choroidal Venous Insufficiency Influencing Pachychoroid Disease

Bacci

Singer

et al. 2022

Invest. Ophthalmol. Vis. Sci.

View full text Add to dashboard Cite

show abstract

“… 25 In order to investigate this postulate, scleral thickness has been evaluated in eyes with CSC and found to be greater than in healthy controls, suggesting its possible role in reducing the trans-scleral resorption of choroidal fluid and causing obstruction to the choroidal blood outflow due to the longer intrascleral path of vortex veins. 26 , 66 The thickened sclera may also impart increased resistance due to the mechanical compression over the intra-scleral course. The ability of UWF imaging to visualize a greater portion of the fundus compared to traditional devices can be useful in analyzing pachychoroid disease-related conditions.…”

Section: Clinical Significance Of Vortex Vein Imagingmentioning

confidence: 99%

Vortex Vein Imaging: What Can It Tell Us?

Verma¹,

Bacci²,

Sarraf³

et al. 2021

OPTH

View full text Add to dashboard Cite

This review article summarizes the patho-anatomy of the vortex veins, the major drainage channels for the choroid, and describes the various pathways of diseases associated with vortex vein abnormalities. This report also details the technical advancements to image the vortex veins, such as ultra-widefield indocyanine green angiography, which are critical to elucidate the importance of the vortices in various retino-choroidal disorders. Future applications of these advanced imaging systems to better understand the role of the vortex veins in health and disease are also discussed.

show abstract

“…The unique aspect of this study, compared to previous manuscripts 28, 29 , is the inclusion of eyes with a later stage of the pachychoroid disease spectrum 30 , PNV, and that this subgroup alone also showed a signi cantly higher AST compared to normal controls.…”

Section: Discussionmentioning

confidence: 75%

Scleral thickness as a risk factor for central serous chorioretinopathy and pachychoroid neovasculopathy

Keidel

Schworm

Langer³

et al. 2022

Preprint

View full text Add to dashboard Cite

Background/Objectives. While the exact pathophysiology of pachychoroid disorders remains unclear, scleral changes inducing increased venous outflow resistance are hypothesized to be involved. This work aims to investigate anterior scleral thickness (AST) as a risk factor for central serous chorioretinopathy (CSC) and pachychoroid neovascularization (PNV). Subjects/Methods. Randomized prospective case-control study performed at the Ludwig Maximilians-University, Department of Ophthalmology. 46 eyes of 46 patients were included, with 23 eyes in the CSC/PNV group (9 eyes with PNV) and 23 eyes in the control group. There was no difference in mean age (51.5 ± 8.0 (36 to 65) vs. 47.0 ± 12.9 (30 to 83) years; p = 0.122) or spherical equivalent (0.60 ± 2.23 (-5.5–4.6) vs. -0,93 ± 2.45 (-4.9–5.8); p = 0.441). In all patients, swept source OCT (SS-OCT) with an anterior segment module was used to measure AST. Subfoveal choroidal thickness (SFCT) was assessed using enhanced depth imaging OCT (EDI-OCT). AST and SFCT were then compared to an age and -refraction-matched control group. Results. A significantly higher AST was found in the CSC/PNV as compared to the control group (403.5 ± 68.6 (278 to 619) vs. 362.5 ± 62.6 (218 to 498) µm; p = 0.028). Moreover, the CSC/PNV group showed a higher SFCT (392.8 ± 92.8 (191–523) vs. 330.95 ± 116.5 (167–609) µm, p = 0.004). Conclusions. Compared to age- and refraction-matched controls, patients with CSC and PNV show a significantly thicker anterior sclera. Scleral thickness might contribute to the venous overload hypothesized to induce pachychoroid phenotypes.

show abstract

A pilot study of scleral thickness in central serous chorioretinopathy using anterior segment optical coherence tomography

Cited by 19 publications

References 33 publications

Ultra-Widefield Indocyanine Green Angiography Reveals Patterns of Choroidal Venous Insufficiency Influencing Pachychoroid Disease

Ultra-Widefield Indocyanine Green Angiography Reveals Patterns of Choroidal Venous Insufficiency Influencing Pachychoroid Disease

Vortex Vein Imaging: What Can It Tell Us?

Scleral thickness as a risk factor for central serous chorioretinopathy and pachychoroid neovasculopathy

Contact Info

Product

Resources

About