Ma Feiyan , Qi Yuan , Niu Chendai , Zhao Xuejing , Liu Ying , Liu Liya
  • Department of Ophthalmology, Second Hospital of Hebei Medical University, Shijiazhuang 050000, China;
Liu Liya, Email: liuliya81@sina.com
Central serous chorioretinopathy; Swept-source optical coherence tomography angiography; Choroidal blood flow; Leakage point
10.3760/cma.j.cn511434-20250506-00199
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Objective To observe the changes of choroidal blood perfusion in the macular area and the leakage point of acute central serous chorioretinitis (CSC). Methods A non-randomized controlled clinical study method was adopted. From March 2022 to March 2023, 70 patients (70 eyes) with monocular acute CSC diagnosed in the Eye Center of the Second Hospital of Hebei Medical University (CSC group) were included in this study. There were 49 male patients with 49 eyes and 21 female patients with 21 eyes. The mean age was (46.70±8.45) years. The duration of disease from symptom onset to presentation was ≤3 months. The contralateral eye of the CSC patient was set as the contralateral eye group. A total of 70 eyes of 70 age-and gender-matched healthy volunteers without systemic diseases were selected as normal control group during the same period. The best corrected visual acuity (BCVA) and swept frequency source optical coherence tomography angiography (SS-OCTA) were performed. BCVA was performed using the international standard visual acuity chart, and was converted to log minimum angle of resolution (logMAR) visual acuity. SS-OCTA examination of macular area was performed using VG200D of Vision Micro Imaging (Henan) Technology Co., LTD. Scanning mode Angio 6 mm×6 mm. According to the classification of diabetic retinopathy Treatment Study Group, the choroid within 6 mm of the macular fovea was divided into three concentric circles centered on the macular fovea, which were the central area with a diameter of 1 mm, the inner ring with a diameter of 1-3 mm, and the outer ring with a diameter of 3-6 mm. The three-dimensional choroidal vascular index (3D-CVI), choroidal vascular volume (3D-CVV), choroidal capillary layer (CCL) and choroidal great vascular layer (CL) perfusion area, choroidal thickness (ChT), and subretinal fluid (SRF) height were recorded by the built-in software of the equipment in the central area, inner ring area, and outer ring area. The Kruskal-Wallis rank sum test was used for comparison between multiple groups. Results The logMAR BCVA was 0.19±0.07 in the CSC group. The subfoveal SRF height was (129±121) μm. Compared with the contralateral eye group and the normal control group, the CCL perfusion area in the central area and the inner ring area of the affected eye in the CSC group was significantly decreased, and the CL perfusion area in the central area was significantly increased (P＜0.05). Compared with the normal control group, 3D-CVI was significantly decreased and 3D-CVV was significantly increased in the CSC group, and the differences were statistically significant (P＜0.05). The difference of 3D-CVV between the contralateral eye group and the normal control group was statistically significant (P＜0.05). The ChT of the central, inner and outer ring regions in the CSC group and the contralateral eye group were significantly higher than those in the normal control group (P＜0.05). The CCL and CL perfusion areas at the leakage point in the CSC group were significantly lower than those in the surrounding area, and the 3D-CVI was higher than that in the surrounding area, the differences were statistically significant (P＜0.05). Conclusion Compared with normal healthy eyes, choroidal thickening and vascular dilatation are found in both the affected and contralateral eyes of patients with acute CSC, and the choroidal capillary hypoperfusion and medium and large vascular dilatation are more obvious in the leakage point of the affected eye than in the surrounding area.

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