Increased Choroidal Vascularity in Central Serous Chorioretinopathy Quantified Using Swept-Source Optical Coherence Tomography

PURPOSE: To investigate the choroidal vascular structural changes in eyes with central serous chorioretinopathy (CSC) by using swept-source optical coherence tomography (SS-OCT). DESIGN: Prospective cross-sectional study. METHODS: We prospectively examined 40 eyes of 34 consecutive patients with CSC. Three-dimensional choroidal images of the macular area, covering 3 x 3 mm and 6 x 6 mm, were obtained with SS-OCT. En face images of the microvasculature of the inner choroid and large choroidal vessel layers were converted to binary images. Choroidal vascular areas were analyzed quantitatively using the binary images. RESULTS: The choroidal vascular area was larger in eyes with CSC (the microvasculature of the inner choroid: 53.4% +/- 2.4%, P = .028; 3 x 3-mm large choroidal vessels: 66.9% 7.1%, P < .001; and 6 x 6-mm large choroidal vessels: 64.8% +/- 7.3%, P < .001) than in age-matched normal eyes (52.2% +/- 1.8%, 54.9% +/- 4.4%, and 53.8% +/- 4.3%, respectively). The choroidal vascular area at the microvasculature of the inner choroid level was larger in multifocal posterior pigment epitheliopathy (55.8% 2.2%) than in classic CSC (53.1% 2.1%, P = .038) and in diffuse retinal pigment epitheliopathy (52.9% +/- 2.6%, P = .042). The subfoveal choroidal thickness was significantly associated with the choroidal vascular area at the level of large choroidal vessels (P < .001). CONCLUSIONS: Increased choroidal vascular area was observed in the whole macula area in eyes with CSC. This finding suggests that CSC may originate from a choroidal circulatory disturbance. (C) 2016 Elsevier Inc. All rights reserved.)