Choroidal thickness in older patients with central serous chorioretinopathy.

Mehreen Adhi,Eduardo A Novais,Caio V Regatieri,Mark Lane,Lauren Branchini,Elias Reichel,Emily D Cole,Jay S Duker,Ricardo Louzada

doi:10.1186/s40942-016-0046-7

Abstract

BackgroundTo investigate the choroidal thickness in older patients with central serous chorioretinopathy (CSCR) compared to age-matched normal subjects.MethodsFifteen patients (30 eyes) with CSCR, all aged ≥60 years, and 21 age-matched normal subjects (21 eyes) underwent high-definition raster scanning using SD-OCT. Both eyes from CSCR patients were included in the analysis. The eyes in patients with CSCR were divided into two groups: active CSCR (17 eyes) if there was foveal-involving subretinal fluid and inactive contralateral eye group (13 eyes). Choroidal thickness was measured from the posterior edge of the retinal pigment epithelium to the choroidal–scleral junction at 500 µm intervals up to 2500 µm temporal and nasal to the fovea (11 locations).ResultsThe mean age of the patients with CSCR was 68.87 ± 6.83 years (mean ± standard deviation). Reliable measurements of choroidal thickness were obtainable in 70.6 % of eyes examined. The choroid was statistically significantly thicker in eyes with both active CSCR (P < 0.001) and inactive contralateral eyes (P < 0.01) when compared to normal age-matched eyes. The subfoveal choroid was 95 µm (P < 0.01) thicker in eyes with active CSCR (338.05 ± 31.42 µm) compared with normal eyes (243.05 ± 13.39 µm). The subfoveal choroid thickness in the inactive contralateral eyes was numerically greater than normal, and it was not statistically significantly thicker compared to the normal eyes (difference—55.68 µm, P > 0.05).ConclusionChoroid in older patients with active CSCR was thicker than the choroid in age-matched normal eyes. It is important to consider CSCR as a differential diagnosis of serous retinal detachment in elderly patients with thickened choroid and to consider SD-OCT as an imaging modality by which to evaluate the choroidal thickness.

Highlights

To investigate the choroidal thickness in older patients with central serous chorioretinopathy (CSCR) compared to age-matched normal subjects
A diagnostic and therapeutic challenge may exist since CSCR, choroidal neovascularization secondary to neovascular age-related macular degeneration and polypoidal choroidal vasculopathy (PCV) can all cause serous retinal detachment [11,12,13,14]
The subfoveal choroid thickness in the inactive contralateral eyes was numerically greater than normal, and it was not statistically significantly thicker compared to the normal eyes

Summary

Introduction

To investigate the choroidal thickness in older patients with central serous chorioretinopathy (CSCR) compared to age-matched normal subjects. On optical coherence tomography (OCT), active CSCR appears as an elevation of the full thickness neurosensory retina from the highly reflective retinal pigmented epithelium (RPE) separated by an optically empty zone. This condition has been linked to increased choroidal vascular permeability [1]. CSCR typically occurs in young healthy male individuals, this condition can occur in older patients as well [8,9,10] In such cases, a diagnostic and therapeutic challenge may exist since CSCR, choroidal neovascularization secondary to neovascular age-related macular degeneration (nAMD) and polypoidal choroidal vasculopathy (PCV) can all cause serous retinal detachment [11,12,13,14]. In a new hypothesis that proposes to unify CSCR and PCV entities into a single disease spectrum, CSCR has been described along with PCV as a late-stage manifestation of pachychoroid disease of the macula [15]

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