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Choroidal vascular alterations evaluated by ultra-widefield indocyanine green angiography in central serous chorioretinopathy

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Abstract

Purpose

This study aims to evaluate choroidal vascular alterations in patients with central serous chorioretinopathy (CSC) using ultra-widefield (UWF) indocyanine green angiography (ICGA).

Methods

This was a retrospective case–control study conducted at a single tertiary eye center. In total, 36 eyes in patients with either unilateral (24 patients) or bilateral (six patients) treatment-naïve CSC and 30 eyes in 24 age-matched controls were evaluated. The number of quadrants with vortex vein engorgement on UWF ICGA was evaluated. Dilated choroidal vessels affecting the macula were regarded as extended vortex vein engorgement. Choroidal vascular hyperpermeability (CVH) area on late-phase ICGA was quantified using stereographic projection. The parameters were compared with clinical and optical coherence tomographic findings.

Results

Eyes with CSC had larger CVH area, thicker choroid, and more quadrants with vortex vein engorgement and extended vortex vein engorgement compared with control eyes (all P < 0.001). In patients with unilateral CSC, affected eyes had larger CVH area, thicker choroid, and more extended vortex vein engorgements compared with unaffected fellow eyes (all P < 0.001), but vortex vein engorgement did not significantly differ. CVH was significantly correlated with extended vortex vein engorgement (P < 0.001) and subfoveal choroidal thickness (P = 0.007).

Conclusions

The increased number and binocular symmetry of engorged vortex veins suggest an anatomical predisposition for CSC. CVH area and extended vortex vein engorgement were indicators of choroidal outflow congestion. These parameters may serve as diagnostic clues or predictors of disease development in eyes with CSC.

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Data availability

Data are available upon reasonable request.

Code availability

Not applicable.

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Funding

This work was supported by a 2020 Yeungnam University research grant. The funding organization had no role in this study including design, collection, analysis, interpretation of data, or approval of manuscript.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, South Korea

    Seongyong Jeong, Wonki Kang, Donghyoun Noh & Min Sagong

  2. Yeungnam Eye Center, Yeungnam University Hospital, #170 Hyunchungro, Nam-gu, Daegu, 42415, South Korea

    Seongyong Jeong, Wonki Kang & Min Sagong

  3. Good Doctors Eye Hospital, Ulsan, South Korea

    Donghyoun Noh

  4. Optos PLC, Dunfermline, UK

    Jano van Hemert

Authors
  1. Seongyong Jeong
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  2. Wonki Kang
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  4. Jano van Hemert
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  5. Min Sagong
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Contributions

Design and conduct of the study, MS; collection and management of data SJ, WK, DN, JH, and MS; analysis and interpretation of data, SJ, WK, DN, and MS; and preparation, review, and approval of the manuscript, SJ, WK, DN, JV, and MS.

Corresponding author

Correspondence to Min Sagong.

Ethics declarations

Ethics approval

The study protocol was approved by the Institutional Review Board of Yeungnam University Hospital.

Consent to participate

Written informed consent was obtained from all participants.

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Not applicable.

Competing interests

S. Jeong, none; W Kang, none; D Noh, none; and M. Sagong, none. J.v.H. is the research director at Optos, a Nikon Company (Employment) and held patents (Improvement in and relating to Imaging of the Eye) pending to Optos PLC.

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Jeong, S., Kang, W., Noh, D. et al. Choroidal vascular alterations evaluated by ultra-widefield indocyanine green angiography in central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol 260, 1887–1898 (2022). https://doi.org/10.1007/s00417-021-05461-0

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