Session Title: Imaging III
Session Date/Time: Saturday 19/09/2015 | 16:30-18:00
Paper Time: 17:02
First Author: : I.Casal PORTUGAL
Co Author(s): : M. Furtado M. Gomes M. Lume S. Pires A. Meireles P. Meneres
PURPOSE:Central serous chorioretinopathy(CSC) is characterized by a macular serous detachment of the neurosensory retina, often associated to small serous detachments of the retinal pigmented epithelium(RPE). Several diagnostic tests such as Enhanced Depth Imaging Optical Coherence Tomography(EDI-OCT) and Indocyanine Green Angiography suggest the presence of typical changes in choroidal vasculature and thickness. We intended to analyze choroidal thickness(CT) of patients with acute and chronic CSC and to evaluate thickness variation after treatment.
Centro Hospitalar do Porto in Porto, Portugal
Case series of patients with CSC observed in our department since January 2012. We considered the CSC as chronic when the detachment of the neurosensory retina/RPE persisted up to 3 months. Patients were divided in 2 groups: Group 1 included patients with acute(untreated) CSC and group 2 included treated patients with chronic CSC. Systemic and ocular medical history were investigated, best corrected visual acuity(BCVA) was assessed and a complete ophthalmic exam was performed in all patients. All patients underwent Choroidal Thickness (CT) measurement with EDI-OCT and choroidal vasculature evaluation with indocyanine green angiography(ICGA).
A total of 28 eyes were included: 8 eyes of 7 patients in group 1 and 20 eyes of 18 patients in group 2. All patients in group 1 were male and the mean age at diagnose was 43,87 years-old. In group 2, 83% were male and the mean age at presentation was 49,25 years old. Two patients in group 1 and three in group 2(one of them with bilateral CSC) were taking systemic corticosteroids to treat systemic inflammatory/auto-immune condition. The mean initial BCVA was 0,72(decimal scale) in group 1 and 0,53 in group 2. In group 2, 18 eyes were treated with low dose photodynamic therapy(PDT) and 2 with full dose PDT, with an average of one session per eye. In group 1, mean subfoveal CT was 377 µm in affected eyes and 305 µm in fellow eyes; ICGA showed choroidal hyperpermeability plaques in all affected eyes and in the majority of the fellow eyes. In group 2 mean subfoveal CT in the affected eyes after therapy was 353 µm and in the fellow eyes 380 µm.
CSC appears to be a bilateral disorder with possible assymetric involvement. Subfoveal CT seems to be increased in both affected and, to a lesser extent, in fellow eyes. Treatment with photodynamic therapy with verteporfin may induce variable choroidal thickness decrease. Signs of choroidal hyperpermeability on ICGA were common findings among naive affected eyes and the majority of the fellow eyes. EDI-OCT allows CT measurement and may have an important role in establishing differential diagnosis of CSC from other causes of neurosensory macular detachment as well as in monitoring disease activity after treatment.