Ciliochoroidal Effusion in Central Serous Chorioretinopathy

Terao, Nobuhiro; Imanaga, Naoya; Wakugawa, Sorako; Sawaguchi, S.; Tamashiro, Tamaki; Yamauchi, Yukihide; Koizumi, Hideki

doi:10.1097/iae.0000000000003376

Cited by 14 publications

(5 citation statements)

References 31 publications

(42 reference statements)

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“…Recently, using an anterior-segment (AS) OCT, we proposed that sclera may induce choroidal circulatory disturbances, based on the fact that CSC eyes had significantly thicker sclera than normal control eyes. 30 , 31 Unexpectedly, choroidal thickness did not simply correlate with scleral thickness in CSC eyes in our pilot study. To elucidate the relationship between scleral thickness and choroidal structure, we aimed to investigate the clinical factors related to the L/S ratio in the posterior choroid in CSC eyes.…”

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confidence: 53%

“…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%

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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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confidence: 53%

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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“…Increased resistance to transscleral outflow is a principal hypothesized mechanism in uveal effusion syndrome [ 24 ], which is characterized by ciliochoroidal effusion and serous retinal detachment. This syndrome, where a histologically altered sclera has been documented and the effectiveness of sclerotomy for particular subtypes is evident [ 25 , 26 ], shares clinical characteristics with CSC and may have a common pathogenic mechanism involving scleral abnormalities [ 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Biomechanical properties measured with dynamic Scheimpflug analyzer in central serous chorioretinopathy

Aoki,

Asaoka,

Azuma

et al. 2024

Graefes Arch Clin Exp Ophthalmol

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Purpose Recent evidence suggests that venous congestion at the vortex vein significantly contributes to the development of central serous chorioretinopathy (CSCR), and sclera is observed to be thicker in affected eyes. This study aims to investigate whether eyes with CSCR exhibit stiff corneas, measured using Corneal Visualization Scheimflug Technology (Corvis ST), which may serve as an indicator of scleral stiffness. Methods This retrospective case–control study comprises 52 eyes from 33 patients diagnosed with CSCR and 52 eyes from 32 normal controls without CSCR. We compared biomechanical parameters measured with Corvis ST and anterior scleral thickness measured using anterior segment swept-source optical coherence tomography between the two groups. Results Age, sex, axial length, intraocular pressure, and central corneal thickness showed no significant differences between the two groups (p > 0.05, linear mixed model). Three biomechanical parameters—peak distance, maximum deflection amplitude, and integrated inverse radius—indicated less deformability in CSCR eyes compared to control eyes. The stress–strain index (SSI), a measure of stiffness, and anterior scleral thickness (AST) at temporal and nasal points were significantly higher in the CSCR eyes. SSI and AST were not correlated, yet both were significantly and independently associated with CSCR in a multivariate logistic regression model. Conclusions Eyes affected by CSCR have stiffer corneas, irrespective of thicker scleral thickness. This suggests that stiffer sclera may play a role in the pathogenesis of CSCR.

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“…Watson sclera may have a role in the pathogenesis of CSC (21). Later studies have also shown that AS OCT is a useful tool to detect changes of sclera in various diseases (22), (30). A recent study using spectraldomain OCT with an AS module by Kaya et al found that scleral thickness was thicker in SLE patients compared with normal control eyes.…”

Section: Discussionmentioning

confidence: 99%

Scleral changes in systemic lupus erythematosus patients using swept source optical coherence tomography

Chen,

Meng,

Sun

et al. 2023

Front. Immunol.

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PurposeThis study aims to examine scleral thickness in patients with systemic lupus erythematosus (SLE) without clinically evident scleritis and episcleritis, utilizing swept-source optical coherence tomography (SS-OCT).MethodsThis cross-sectional single center study compared scleral thickness (Nasal scleral thickness 1mm, 2mm, 3mm, 6mm from scleral spur; Temporal scleral thickness 1mm, 2mm, 3mm, 6mm from scleral spur) in 73 SLE patients without clinically evident scleritis and episcleritis and 48 healthy volunteers with SS-OCT. Further, we investigated the correlation between scleral thickness in SLE patients and various parameters including laboratory markers, disease duration, disease activity, and organ involvement.ResultsAcross all measured sites (nasal scleral thickness at distances of 1mm, 2mm, 3mm, and 6mm from the scleral spur, and temporal scleral thickness at the same distances), the scleral thickness in the SLE group was significantly greater than that in the control group (all p-values <0.001). SLE patients with a disease duration of 5 years or less exhibited a higher scleral thickness compared to those with a more prolonged disease duration. Patients with a higher erythrocyte sedimentation rate (ESR) had a thinner temporal scleral thickness. However, no significant associations were identified between scleral thickness and disease activity, organ involvement, or other laboratory markers.ConclusionScleral thickness measured by SS-OCT was higher in SLE patients than healthy controls. Changes in scleral thickness in SLE patients are related to disease duration and ESR. SS-OCT can detect asymptomatic structural changes in SLE patients and may be a useful tool in the evaluation of early scleral abnormality.

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Ciliochoroidal Effusion in Central Serous Chorioretinopathy

Cited by 14 publications

References 31 publications

Relationship Between Scleral Thickness and Choroidal Structure in Central Serous Chorioretinopathy

Relationship Between Scleral Thickness and Choroidal Structure in Central Serous Chorioretinopathy

Biomechanical properties measured with dynamic Scheimpflug analyzer in central serous chorioretinopathy

Scleral changes in systemic lupus erythematosus patients using swept source optical coherence tomography

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