Assessment of Macular Choroidal Thickness by Optical Coherence Tomography and Angiographic Changes in Central Serous Chorioretinopathy

Objective: To investigate the relationship between macular choroidal thickness measured by high-penetrating swept-source optical coherence tomography (SS-OCT) and angiographic findings in central serous chorioretinopathy (CSC). Design: Prospective cross-sectional case series. Participants and Controls: Thirty-four patients with CSC (44 eyes) and 17 volunteer subjects (17 normal eyes). Methods: All subjects underwent a comprehensive ophthalmologic and SS-OCT prototype examination. All patients with CSC also underwent simultaneous fluorescein angiography (FA) and indocyanine green angiography (IA). Mean regional choroidal thickness measurements on the Early Treatment Diabetic Retinopathy Study (ETDRS) layout and squared sector grids were obtained by 3-dimensional raster scanning using SS-OCT. Main Outcome Measures: Macular choroidal thickness and angiographic abnormalities. Results: Mean whole macular choroidal thickness in eyes with CSC (total, 329.3 +/- 83.0 mu m; classic CSC, 326.9 +/- 83.1 mu m; chronic CSC, 325.4 +/- 93.3 mu m; and multifocal posterior pigment epitheliopathy, 359.0 +/- 15.5 mu m) was greater than that in normal eyes (233.0 +/- 67.0 mu m) (P < 0.001). In unilateral cases, mean whole macular choroidal thickness was greater in eyes with unilateral CSC than in unaffected fellow eyes (P = 0.021). There was no significant difference in choroidal thickness between active eyes and resolved eyes in any of the ETDRS sectors. Mean choroidal thickness was greater in areas with leakage on FA than in areas without leakage (P = 0.001). Mean choroidal thickness was greater in areas with choroidal vascular hyperpermeability and in areas with punctate hyperfluorescent spots on IA than in unaffected areas (P < 0.001 for both). Conclusions: Increased choroidal thickness was observed in the whole macular area of eyes with any of the CSC subtypes. Choroidal thickness was related to leakage from the retinal pigment epithelium, choroidal vascular hyperpermeability, and punctate hyperfluorescent lesions. These findings provide evidence that CSC may be caused by focally increased hydrostatic pressure in the choroid. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references. Ophthalmology 2012;119:1666-1678 (c) 2012 by the American Academy of Ophthalmology.