Thick choroid in patients with central serous chorioretinopathy

[MyVisionTest]

The choroid of patients with central serous chorioretinopathy (CSCR)
is abnormally thick, according to a new study.

CSCR is a disease of young and middle-aged adults that frequently
manifests symptomatically in one eye, while up to 18% of cases may be
bilateral. Research indicates that the disease process in CSCR is more
diffuse and shows bilateral retinochoroidal dysfunction, even when the
disease is manifesting clinically only in one eye. Though the cause of
CSCR remains unknown, it is believed that abnormalities in choroidal
circulation make overlying retinal pigment epithelium dysfunctional,
resulting in the development of a serous retinal detachment.
Photodynamic therapy, laser photocoagulation and pharmacological
agents have been used to treat CSCR. However, these treatment options
serve only to shorten the duration of symptoms and have no effect on
the recurrence rate or the final visual acuity.

Patients with CSCR underwent enhanced depth imaging spectral-domain
optical coherence tomography, which was obtained by positioning a
spectral-domain optical coherence tomography device close enough to
the eye to acquire an inverted image. Seven sections, each comprising
100 averaged scans, were obtained within a 5° x 30° rectangle
to encompass the macula. The subfoveal choroidal thickness was
measured from the outer border of the retinal pigment epithelium to
the inner scleral border.

The mean age of subjects undergoing enhanced depth imaging
spectral-domain optical coherence tomography was 59 years. Seventeen
of 19 patients (89.5%) were men, and 12 (63.2%) patients had bilateral
clinical disease. The choroidal thickness measured in 28 eligible eyes
of the 19 patients was 505 µm, which was significantly greater
than the choroidal thickness in normal eyes (P = 0.001).

The investigators conclude enhanced depth imaging spectral-domain
optical coherence tomography demonstrated a very thick choroid in
patients with central serous chorioretinopathy. This finding provides
additional evidence that central serous chorioretinopathy may be
caused by increased hydrostatic pressure in the choroid.

Retina. 2009 Nov-Dec;29(10):1469-73

http://www.ncbi.nlm.nih.gov/pubmed/19898183

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