Choroidal vascular abnormalities by UWF ICGA in central serous chorioretinopathy

Abstract

PurposeTo evaluate vortex vein engorgement and choroidal vascular hyperpermeability in patients with central serous chorioretinopathy (CSC) using ultra‐widefield indocyanine green angiography (UWF ICGA).MethodsTwenty two patients with unilateral (19 patients) or bilateral (3 patients) CSC were consecutively included and imaged by UWF autofluorescence, fluorescein angiography and ICGA, and spectral domain optical coherence tomography (OCT). The number of quadrant of vortex vein engorgement was evaluated in the early phase of ICGA, which was classified as effective if the dilated choroidal vessels affect the macula. The area of choroidal vascular hyperpermeability was quantified in the late phase using by stereographic projection method. And they were correlated with clinical findings and OCT features.ResultsIn all affected eyes, choroidal hyperpermeability from dilated choroidal vessels was observed in association with 1 or more engorged vortex vein. Affected eyes showed significantly greater choroidal hyperpermeability area (P < 0.001) and thicker subfoveal choroidal thickness (P = 0.022) compared with unaffected eyes although both eyes in the patients with unilateral CSC demonstrated symmetry of vortex congestion (78.1%). The choroidal vascular hyperpermeability was significantly correlated with subfoveal choroidal thickness (P=0.012, rho=0.493) and the height of subretinal fluid (P=0.012, rho=0.514). The number of quadrant of the effective vortex vein engorgement was correlated with subfoveal choroidal thickness (P=0.010, rho=0.505).ConclusionsUWF ICGA could demonstrate vortex vein engorgement and choroidal vascular hyperpermeability, suggesting outflow congestion as a potential contributor to the pathogenesis of CSC. And they may serve as diagnostic clues or even predictors of disease course.