Assessment of Choroidal Topographic Changes by Swept Source Optical Coherence Tomography After Photodynamic Therapy for Central Serous Chorioretinopathy

Abstract

To investigate the relationship between choroidal thickness and angiographic abnormalities in central serous chorioretinopathy (CSC) eyes by swept-source optical coherence tomography (swept-OCT), before and after half-fluence photodynamic therapy (PDT). Prospective interventional case series. Consecutive patients presenting with treatment-naive active CSC underwent a complete ophthalmologic examination, including swept-OCT at study entry and at 7 days and 30 days after treatment with half-fluence PDT. The main outcome measures were changes in choroidal maps after PDT (mean ± SD) and the relationship between choroidal thickness and angiographic abnormalities. Of 12 patients (2 females, 10 males; mean age, 55.6 ± 14.0 years), 12 eyes were included. At study entry, mean choroidal thickness measured in the center of the fovea was significantly thicker in the study eyes as compared to the fellow eyes (420.7 ± 107.5 μm vs 349.2 ± 109.7 μm, respectively; P = 0.016). Mean choroidal thickness in the center of the fovea significantly decreased in the study eyes at both 7 days (380.2 ± 113 μm; P = 0.005) and 30 days after PDT (362.3 ± 111 μm; P = 0.002). A similar significant choroidal thinning was recorded in each early treatment of diabetic retinopathy study (ETDRS) applied to 3D swept-OCT maps. At each time point, mean choroidal thickness was significantly thicker in sectors with than in sectors without angiographic abnormalities (421 ± 102.4 μm vs 397.6 ± 96.5 μm, P = 0.002 at study entry; 381.2 ± 106.6 μm vs 364 ± 101.2 μm, P = 0.01 at day 7; 366.3 ± 103.2 μm vs 347.2 ± 99.6 μm at day 30). Using swept-OCT, we demonstrated that in active CSC, choroidal thickness is increased to a greater extent in areas characterized by angiographic abnormalities. This increased choroidal thickness may persist even after PDT.