Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar 7;12(6):2088.
doi: 10.3390/jcm12062088.

Intervortex Venous Anastomosis in the Macula in Central Serous Chorioretinopathy Imaged by En Face Optical Coherence Tomography

José Ignacio Fernández-Vigo  1   2 , Daniela Rego-Lorca  1 , Francisco Javier Moreno-Morillo  1   3 , Bárbara Burgos-Blasco  1 , Alicia Valverde-Megías  1 , Carmen Méndez-Hernández  1 , Lorenzo López-Guajardo  1 , Juan Donate-López  1
Affiliations

Intervortex Venous Anastomosis in the Macula in Central Serous Chorioretinopathy Imaged by En Face Optical Coherence Tomography

José Ignacio Fernández-Vigo et al. J Clin Med. .

Abstract

Purpose: To assess the presence of macular intervortex venous anastomosis in central serous chorioretinopathy (CSCR) patients using en face optical coherence tomography (EF-OCT).

Methods: A cross-sectional study where EF-OCT 6 × 6 and 12 × 12 mm macular scans of patients with unilateral chronic CSCR were evaluated for anastomosis between vortex vein systems in the central macula. The presence of prominent anastomoses was defined as a connection with a diameter ≥150 µm between the inferotemporal and superotemporal vortex vein systems which crossed the temporal raphe. Three groups were studied: CSCR eyes (with an active disease with the presence of neurosensorial detachment; n = 135), fellow unaffected eyes (n = 135), and healthy eyes as controls (n = 110). Asymmetries, abrupt termination, sausaging, bulbosities and corkscrew appearance were also assessed.

Results: In 79.2% of the CSCR eyes there were prominent anastomoses in the central macula between the inferotemporal and superotemporal vortex vein systems, being more frequent than in fellow eyes and controls (51.8% and 58.2% respectively). The number of anastomotic connections was higher in the affected eye group (2.9 ± 1.8) than in the unaffected fellow eye group (2.1 ± 1.7) and the controls (1.5 ± 1.6) (p < 0.001). Asymmetry, abrupt terminations and the corkscrew appearance of the choroidal vessels were more frequent in the affected eyes, although no differences in sausaging or bulbosities were observed.

Conclusions: Intervortex venous anastomoses in the macula were common in CSCR, being more frequently observed in affected eyes than in fellow unaffected eyes and healthy controls. This anatomical variation could have important implications concerning the pathogenesis and classification of the disease.

Keywords: central serous chorioretinopathy; choroidal vessels; en face optical coherence tomography; intervortex veins anastomosis; pachychoroid disease.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
En face optical coherence tomography of the macular region used to analyze the presence of intervortex veins anastomosis in a cube scan of 6 × 6 mm and 12 × 12 mm in central serous chorioretinopathy (CSCR) eyes (upper row) and fellow unaffected eyes (bottom row).
Figure 2
Figure 2
(A) En face optical coherence tomography of the macular region showing large anastomoses in a patient affected by central serous chorioretinopathy (CSCR). (B) B-scan showing the pachyvessels on the choroid in the central area.
Figure 3
Figure 3
Examples of en face optical coherence tomography images of the choroidal vessel characteristics assessed. (A) Asymmetry with predominance of the superotemporal vessels. (B) Sausaging of the choroidal vessels (arrow) and corkscrew vessel (dotted circle). (C) Corkscrew vessels (dotted circles) and bulbosity (arrow). (D) Abrupt termination of a choroidal vessel. (E) Bulbosity of a choroidal vessel (arrow). (F) Sausaging of a choroidal vessel (arrows).
Figure 4
Figure 4
En face optical coherence tomography and the corresponding B scan of the macular region to analyze the presence of intervortex venous anastomosis. (A,B): example of an eye affected by central serous chorioretinopathy (CSCR). (C,D): Fellow unaffected CSCR eye. (E,F): example of a healthy control.
See this image and copyright information in PMC

References

    1. Chhablani J., Cohen F.B., Aymard P., Beydoun T., Bousquet E., Daruich-Matet A., Matet A., Zhao M., Cheung C.M.G., Freund K.B., et al. Multimodal Imaging-Based Central Serous Chorioretinopathy Classification. Ophthalmol. Retin. 2020;4:1043–1046. doi: 10.1016/j.oret.2020.07.026. - DOI - PubMed
    1. Kaye R., Chandra S., Sheth J., Boon C.J.F., Sivaprasad S., Lotery A. Central serous chorioretinopathy: An update on risk factors, pathophysiology and imaging modalities. Prog. Retin. Eye Res. 2020;79:100865. doi: 10.1016/j.preteyeres.2020.100865. - DOI - PubMed
    1. Spaide R.F., Rochepeau C., Kodjikian L., Garcia M.A., Coulon C., Burillon C., Denis P., Delaunay B., Mathis T., Matet A., et al. Choriocapillaris Flow Features Follow a Power Law Distribution: Implications for Characterization and Mechanisms of Disease Progression. Graefe’s Arch. Clin. Exp. Ophthalmol. 2019;257:905–912. doi: 10.1016/j.ajo.2016.07.023. - DOI - PubMed
    1. Daruich A., Matet A., Dirani A., Bousquet E., Zhao M., Farman N., Jaisser F., Behar-Cohen F. Central serous chorioretinopathy: Recent findings and new physiopathology hypothesis. Prog. Retin. Eye Res. 2015;48:82–118. doi: 10.1016/j.preteyeres.2015.05.003. - DOI - PubMed
    1. Cheung C.M.G., Lee W.K., Koizumi H., Dansingani K., Lai T.Y.Y., Freund K.B. Pachychoroid disease. Eye. 2019;33:14–33. doi: 10.1038/s41433-018-0158-4. - DOI - PMC - PubMed