Quantitative analysis of choroidal vasculature in central serous chorioretinopathy using ultra-widefield swept-source optical coherence tomography angiography

We aimed to quantitatively compare the choroid blood flow and choroid thickness at the periphery among eyes with central serous chorioretinopathy (CSC), fellow eyes and healthy eyes using ultra-widefield swept-source optical coherence tomography angiography (UWF SS-OCTA). Retrospective analysis of 49 patients with CSC (98 eyes, including unaffected fellow eyes) and 49 age and sex matched controls were included. We obtained 3-dimensional data of vertical 20 mm x horizontal 24 mm x scan depth 6 mm, comprising 9 subfields (superotemporal, upper, superonasal, temporal, central, nasal, inferotemporal, lower, inferonasal regions). CSC eyes presented with greater density of large-vessel choroidal layer in all the 9 subfields compared with controls. Compared with normal eyes, CSC eyes had greater choroidal thickness (superotemporal, upper, superonasal, temporal, central, nasal, inferotemporal, and inferonasal subfields) and choroidal volume (superotemporal, upper, superonasal, temporal, central, and nasal subfields). Compared with control eyes, the choriocapillaris density in the superotemporal, inferotemporal and inferonasal subfields was greater in patients with CSC. Our study may provide further evidence for the congestion of vortex vein in the pathogenesis of CSC. UWF SS-OCTA can be used to evaluate the abnormalities of the choroidal structures even at the periphery in eyes with CSC.

Automated summary

This study aimed to compare choroid blood flow and choroid thickness in eyes with central serous chorioretinopathy (CSC), fellow eyes, and healthy eyes using ultra-widefield swept-source optical coherence tomography angiography (UWF SS-OCTA). Results showed that CSC eyes had greater density of large-vessel choroidal layer, choroidal thickness, and volume compared to normal eyes. Compared to control eyes, CSC patients exhibited higher choriocapillaris density in certain subfields. This study may provide further evidence for the role of vortex vein congestion in the pathogenesis of CSC. UWF SS-OCTA can effectively evaluate choroidal abnormalities in CSC eyes, even at the periphery.