The Association of Pachydrusen Characteristics with Choroidal Thickness and Patient's Age in Polypoidal Choroidal Vasculopathy versus Central Serous Chorioretinopathy

Abstract

We investigated the relationship between pachydrusen and choroidal thickness and age in eyes with polypoidal choroidal vasculopathy (PCV) and fellow eyes, compared to eyes with central serous chorioretinopathy (CSC). This retrospective study included 89 eyes with PCV and 146 eyes with CSC. The number, location, and shape of the pachydrusen and their association with choroidal thickness and age were analyzed. PCV eyes showed pachydrusen more frequently than eyes with CSC (52% vs. 20%, p < 0.001). Large solitary type and clustered type were more frequent in PCV eyes compared to CSC eyes (p = 0.003 and p = 0.001, respectively). Subfoveal choroidal thickness was associated with pachydrusen in eyes with PCV (odds ratio [OR] 1.006, 95% confidence interval [CI] 1.001−1.011, p = 0.027), while age was associated with pachydrusen in CSC eyes (OR 1.137, 95% CI, 1.073−1.205; p < 0.001). Pachydrusen were localized directly over the pachyvessel on optical coherence tomographic findings in approximately two thirds of PCV eyes and fellow eyes (62% and 67%, respectively). Risk factors for pachydrusen differ according to diseases. The presence of pachydrusen was associated with choroidal thickness in PCV, while the association with age was more prominent in CSC.

Keywords: central serous chorioretinopathy; choroid; pachydrusen; polypoidal choroidal vasculopathy.

Figure 1

Representative cases of pachydrusen in CSC eye. (A) A 53-year-old male patient presented with CSC in his right eye, with a pachydrusen (blue arrows) in FP. (B) A solitary pachydrusen is noted superior to the fovea, and (C) thick subfoveal choroidal thickness (533 μm) with subretinal fluid is noted in the enhanced depth imaging mode. CSC = central serous chorioretinopathy; FP = fundus photography.

Figure 2

Representative cases of pachydrusen in PCV eye. (A) An 80-year-old male patient presented with subretinal hemorrhage due to PCV in his left eye, with a pachydrusen (blue arrows) at the temporal retina in FP. (B) Pachydrusen is noted at the temporal side in OCT. OCT = optical coherence tomography; PCV = polypoidal choroidal vasculopathy.

Figure 3

Representative cases of pachydrusen and pachyvessel. (A–C) An 80-year-old male patient diagnosed with PCV in his left eye presents with pachydrusen (blue arrows) in FP and pachydrusen and pachyvessel (red arrows) in OCT in the fellow eye. (D–F) A 69-year-old male patient diagnosed with PCV in his left eye presents with pachydrusen in FP and pachydrusen and pachyvessel in OCT in the fellow eye. (G–I) A 62-year-old male diagnosed with PCV in his left eye presents with pachydrusen in FP and pachydrusen and pachyvessel in OCT, as well as a relatively thin subfoveal choroidal thickness measured as 200 μm in the enhanced depth imaging mode. FP = fundus photography; OCT = optical coherence tomography; PCV = polypoidal choroidal vasculopathy.