Choroidal Vascularity Map in Unilateral Central Serous Chorioretinopathy: A Comparison with Fellow and Healthy Eyes

Abstract

Background: To map the choroidal vascularity index and compare two eyes in patients with unilateral central serous chorioretinopathy (CSCR). Methods: This was a retrospective, observational study performed in patients with unilateral CSCR. Choroidal thickness (CT) and Choroidal vascularity index (CVI) were measured and mapped in various zones according to the early treatment diabetic retinopathy (ETDRS) grid. Results: A total of 20 CSCR patients (20 study and 20 fellow eyes) were included in the study. Outer nasal region CT was seen to be significantly lower than central CT (p = 0.042) and inner nasal CT (p = 0.007); outer ring CT was significantly less than central (p = 0.04) and inner ring (p = 0.01) CT in CSCR eyes. On potting all the CVI values against the corresponding CT values, a positive correlation was seen in CSCR eyes (r = 0.54, p < 0.01), which was slightly weaker in fellow eyes (r = 0.3, p < 0.01) and a negative correlation was seen in healthy eyes (r = −0.262, p < 0.01). Conclusions: Correlation between CVI and CT was altered in CSCR eyes as compared to fellow and normal eyes with increasing CVI towards the center of the macula and superiorly in CSCR eyes.

Three-dimensional choroidal vascularity index in central serous chorioretinopathy using ultra-widefield swept-source optical coherence tomography angiography

“…Yang et al had reported the mean 3D-CVI in the 12 × 12 mm scan area was 0.35 in the eyes with CSC and 0.30 in the control eyes ( 13 ). In our study, the mean CVI in CSC eyes was 42%, statistically higher than that in control eyes (39%), consistent with previous studies ( 12 , 13 , 27 ). Similar to the study by Yang et al ( 13 ), the CVIs in drainage route of choroidal veins, including superotemporal, inferotemporal and inferonasal were significantly higher in CSC eyes, indicating the congestion of vortex vein may play a role in the pathogenesis.…”

Choroidal Vascularity Index versus Choroidal Thickness as Biomarkers of Acute Central Serous Chorioretinopathy

“…A volumetric study of the choroid to quantify the CVI in different areas of the macula is currently feasible, as published by Sahoo et al [15] These authors demonstrated that eyes with acute CSCR show a growing trend of CVI toward the center of the macula, in contrast to a decreasing trend toward the center in fellow eyes and control patients [15] . CSCR shows choroidal alterations when compared to healthy eyes like increased CT and CVI both in acute and chronic cases [36] , and these changes can be focal or diffuse involving the entire choroid.…”

“…Sahoo et al [15] performed a correlation study between both parameters using the mean value obtained from all areas studied, finding a positive correlation between them in acute CSCR ( r = 0.58; p = 0.1). Fellow eyes showed a weak correlation ( r = 0.183; p = 0.64), while healthy eyes drew similar results ( r = 0.236; p = 0.54).…”

“…The rise of the CVI in the central macula in acute CSCR cases suggests a disproportionate increase in luminal area, with a maximum effect over the subfoveal choroid. This is why the subfoveal CVI may potentially be used as a reliable biomarker, with distinct behavior in different choroidal locations [15] . Sahoo et al [15] suggest that choroidal vessels in this region are more sensitive to stimuli in comparison to other locations of the choroid and that the correlation between the CVI and CT in acute CSCR could be used to detect subclinical activity.…”

“…This is why the subfoveal CVI may potentially be used as a reliable biomarker, with distinct behavior in different choroidal locations [15] . Sahoo et al [15] suggest that choroidal vessels in this region are more sensitive to stimuli in comparison to other locations of the choroid and that the correlation between the CVI and CT in acute CSCR could be used to detect subclinical activity. They insist on the need for further studies to validate this association.…”