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. 2003 Jun;87(6):709-12.
doi: 10.1136/bjo.87.6.709.

Features of abnormal choroidal circulation in central serous chorioretinopathy

N Kitaya  1 , T Nagaoka, T Hikichi, R Sugawara, K Fukui, S Ishiko, A Yoshida
Affiliations

Features of abnormal choroidal circulation in central serous chorioretinopathy

N Kitaya et al. Br J Ophthalmol. 2003 Jun.

Abstract

Aims: To evaluate abnormalities in the choroidal circulation in cases of central serous chorioretinopathy (CSC).

Methods: A complete clinical ophthalmological examination was performed using simultaneous fluorescein and indocyanine green (ICG) angiography with a confocal scanning laser ophthalmoscopy and the digital images analysed in 36 consecutive patients with acute CSC. To quantify the choroidal circulation, the foveal choroidal blood flow was measured in 11 patients using laser Doppler flowmetry.

Results: Fluorescein angiography showed focal leakage from the retinal pigment epithelium in all patients. ICG angiography revealed delays in arterial filling in 27 eyes (75%), and fluorescein angiography showed small hypofluorescent points around the leakage in 27 eyes (75%). Abnormal choroidal hyperfluorescence was observed in 30 eyes (83%). The choroidal blood flow in eyes with CSC was 45% lower than in fellow eyes (p<0.01).

Conclusion: Decreased choroidal blood flow in CSC was demonstrated for the first time. The decreased choroidal blood flow might be correlated with the small, localised hypofluorescent areas, which may indicate non-perfused areas of the choriocapillaris that are frequently seen during ICG angiography.

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Figures

Figure 1
Figure 1
Typical cases of delayed arterial filling using ICG angiography. (A) Right eye of a 52 year old man with CSC. ICG angiography (angle, 30°) 24 seconds after dye injection shows delayed arterial filling in the foveal region (arrows). (B) Right eye of a 41 year old man. Delayed arterial filling is observed 33 seconds after dye injection (arrows) (angle, 30°).
Figure 2
Figure 2
Small, localised hypofluorescent areas around the fluorescein leaking point. (A) The left eye of a 49 year old man with CSC visualised by fluorescein angiography (angle, 10°) 53 seconds after dye injection has fluorescein leakage near the foveal region (thin line). (B) Simultaneous image of ICG angiography. The thin line indicates the same region of fluorescein leakage. Note that the small, localised hypofluorescent areas are seen around the leaking point. (C) Late phase fluorescein angiography (angle, 10°) 10 minutes after dye injection in the right eye of a 32 year old man with CSC shows fluorescein leakage and weak pooling. (D) Simultaneous image of ICG angiography. Localised hypofluorescent areas are seen around the fluorescein leaking point.
Figure 3
Figure 3
Abnormal choroidal hyperfluorescence with ICG angiography. (A) The right eye of a 37 year old man with CSC. ICG angiography (angle, 10°) 14 minutes after dye injection shows hyperfluorescent area about 1.5 disc diameters in size (arrows). (B) The right eye of a 32 year old man visualised during ICG angiography. A hyperfluorescent area with localised hypofluorescence is seen 12 minutes after dye injection (arrows) (angle, 10°).
Figure 4
Figure 4
Relative foveolar choroidal blood flow (expressed in AU) in eyes with CSC and fellow eyes.
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