Assessment of the anterior scleral thickness in central serous chorioretinopathy patients by optical coherence tomography

Fernández‐Vigo, José Ignacio; Moreno-Morillo, Francisco Javier; Shi, Hongcheng; Ly-Yang, F.; Burgos-Blasco, Bárbara; Güemes-Villahoz, Noemí; Donate-López, J.; García‐Feijoó, Julián

doi:10.1007/s10384-021-00870-4

Cited by 22 publications

(7 citation statements)

References 24 publications

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“…Because thick sclera seen in CSC eyes may increase vortex vein resistance, reduce choroidal venous outflow, and induce disturbances of the choroidal circulation in the posterior pole, it may be important to measure the thickness of the sclera surrounding the vortex veins. By contrast, Fernández-Vigo et al 22 reported no differences in any of the anterior scleral thickness measurements between eyes with CSC and unaffected fellow eyes, thus supporting the results of our current study. The authors measured the temporal and nasal anterior scleral thicknesses at 0, 1, and 2 mm from the scleral spur.…”

Section: Discussionsupporting

confidence: 90%

Scleral Thickness in the Fellow Eyes of Patients With Unilateral Central Serous Chorioretinopathy

Aichi,

Terao,

Imanaga

et al. 2023

Retina

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The sclera is reportedly thicker in eyes with central serous chorioretinopathy (CSC) than in healthy control eyes. We compared the scleral thicknesses of the affected and unaffected fellow eyes of patients with unilateral CSC.Methods: We retrospectively examined the findings of 115 patients with unilateral CSC. Comparisons of the spherical equivalent, axial length, anterior chamber depth, subfoveal choroidal thickness, scleral thickness, and presence of peripheral ciliochoroidal effusion of the affected and fellow eyes were made. Using anterior segment optical coherence tomography, scleral thickness was measured vertically, 6 mm posterior to the scleral spur in the superior, temporal, inferior, and nasal directions.Results: No significant differences in scleral thickness in all four directions, spherical equivalent, axial length, anterior chamber depth, and frequency of ciliochoroidal effusion were found between the affected and unaffected fellow eyes. The only significant difference between the affected and fellow eyes was observed in the subfoveal choroidal thickness (398.8 mm vs. 346.6 mm, P , 0.001).Conclusion: A thickened choroid seems to have a direct effect on CSC development. By contrast, the affected and fellow eyes showed no significant difference in scleral thickness, indicating that scleral thickening may be a predisposing factor for the development of CSC.

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Section: Discussionsupporting

confidence: 90%

Scleral Thickness in the Fellow Eyes of Patients With Unilateral Central Serous Chorioretinopathy

Aichi,

Terao,

Imanaga

et al. 2023

Retina

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“…Recently, using AS OCT, we demonstrated that CSC eyes had significantly thicker sclera than normal control eyes, suggesting an overlap with the pathogenesis of uveal effusion syndrome, 30 and subsequent reports supported our finding. 31 , 38 , 39 CSC and uveal effusion syndrome characterized by thick sclera share the same clinical features, such as a thick choroid and SRD. 40 , 41 Choroidal blood flow is excreted out of the eye by four or more vortex veins.…”

Section: Discussionmentioning

confidence: 97%

Relationship Between Scleral Thickness and Choroidal Structure in Central Serous Chorioretinopathy

Imanaga

Terao

Sonoda

et al. 2023

Invest. Ophthalmol. Vis. Sci.

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Purpose Central serous chorioretinopathy (CSC) is a retinal disorder characterized by serous retinal detachment with or without pigment epithelial detachment in the posterior pole of the eye. We aimed to elucidate the relationship between scleral thickness and choroidal structure in CSC eyes. Methods This single-center retrospective study included 111 eyes of 111 CSC patients. Using swept-source optical coherence tomography, the horizontal cross-sectional images of the posterior choroid were converted to binary images by semiautomated software. The luminal and stromal areas of the choroid were measured, and the luminal/stromal (L/S) ratios of the whole choroid (WC), inner choroid, and outer choroid (OC) at 1500 µm, 3000 µm, and 7500 µm ranges centered on the fovea were calculated. Correlations of L/S ratio and age, spherical equivalent, axial length, subfoveal choroidal thickness (SCT), and scleral thickness were determined. Scleral thickness was measured vertically, 6 mm posterior to the scleral spur in four directions. Results SCT and mean scleral thickness were significantly positively correlated with the L/S ratio in all ranges of WC and OC. Multiple regression analysis found that SCT and mean scleral thickness were significantly correlated with the L/S ratio, and the strength of correlation of mean scleral thickness (WC: 0.386, P < 0.001; OC: 0.391, P < 0.001) was greater than that of SCT (WC: 0.368, P < 0.001; OC: 0.383, P < 0.001) in 7500 µm range. Conclusions Thick sclera appeared to play a role in an increase in the luminal component of the posterior choroid in CSC eyes.

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“…Regarding the potential origin of pachyvessels, an increased scleral thickness, either leading to narrowing of the passage of the ampulla through the sclera or a decreased permeability of the sclera to fluids, has been proposed to play a role (Fernández‐Vigo et al. 2021 ; Lee et al. 2021 ; Spaide et al.…”

Section: The Pachychoroid Disease Spectrum: Venous Overload Of Myster...mentioning

confidence: 99%

Choroidal arteriovenous anastomoses: a hypothesis for the pathogenesis of central serous chorioretinopathy and other pachychoroid disease spectrum abnormalities

Brinks

Dijk

Meijer

et al. 2022

Acta Ophthalmologica

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The pachychoroid disease spectrum (PDS) includes several chorioretinal diseases that share specific choroidal abnormalities. Although their pathophysiological basis is poorly understood, diseases that are part of the PDS have been hypothesized to be the result of venous congestion. Within the PDS, central serous chorioretinopathy is the most common condition associated with vision loss, due to an accumulation of subretinal fluid in the macula. Central serous chorioretinopathy is characterized by distinct risk factors, most notably a high prevalence in males and exposure to corticosteroids. Interestingly, sex differences and corticosteroids are also strongly associated with specific types of arteriovenous anastomoses in the human body, including dural arteriovenous fistula and surgically created arteriovenous shunts. In this manuscript, we assess the potential of such arteriovenous anastomoses in the choroid as a causal mechanism of the PDS. We propose how this may provide a novel unifying concept on the pathophysiological basis of the PDS, and present cases in which this mechanism may play a role.

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Assessment of the anterior scleral thickness in central serous chorioretinopathy patients by optical coherence tomography

Cited by 22 publications

References 24 publications

Scleral Thickness in the Fellow Eyes of Patients With Unilateral Central Serous Chorioretinopathy

Scleral Thickness in the Fellow Eyes of Patients With Unilateral Central Serous Chorioretinopathy

Relationship Between Scleral Thickness and Choroidal Structure in Central Serous Chorioretinopathy

Choroidal arteriovenous anastomoses: a hypothesis for the pathogenesis of central serous chorioretinopathy and other pachychoroid disease spectrum abnormalities

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