Topographical Choroidal Thickness Change Following PDT for CSC: An OCT Case Report

Department of Ophthalmology, The Eye Institute, Medical College of Wisconsin, 925 North 87th Street, Milwaukee, WI 53226, USA.
Journal of Ophthalmology (Impact Factor: 1.43). 01/2012; 2012:347206. DOI: 10.1155/2012/347206
Source: PubMed

ABSTRACT Purpose. To describe topographical changes in choroidal thickness as measured by optical coherence tomography following photodynamic therapy (PDT) for central serous chorioretinopathy (CSC). Methods. Case report. Results. By 1 month following PDT, mean (SD) choroidal thickness decreased from 562 microns (24) to 424 microns (27) (P < 0.01) at 3 mm temporal to fovea, 483 microns (9) to 341 microns (21) (P < 0.01) at 1.5 mm temporal to fovea, 576 microns (52) to 370 microns (81) (P < 0.01) under the fovea, 442 microns (30) to 331 microns (54) (P < 0.04) at 1.5 mm nasal to fovea, and 274 microns (39) to 171 microns (17) (P < 0.01) at 3 mm nasal to fovea. The Location of greatest choroidal thickness (648 microns) prior to treatment was at point of leakage on fluorescein angiogram (FA). This region decreased to 504 microns following treatment. Conclusion. A decrease in choroidal thickness can be seen following PDT for CSC as far as 3 mm temporal and 3 mm nasal to fovea. The Location of greatest choroidal thickness may be at point of leakage on FA.

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    • "Choroidal thickness varies based on the nature of posterior segment pathology as well. For instance, choroidal thickness increases in hyperopia [24], acute VKH [14,15,18], central serous chorioretinopathy [27,28], and polypoid choroidal vasculopathy [29,30]. On the other hand, loss of choroidal mass has been seen in high myopia [24], age-related macular degeneration [29], macular hole [30], degenerative choroidal disease [31], and ocular inflammation [32]. "
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    ABSTRACT: The aim of this study was to determine the clinical significance of posterior choroidal thickness and vascular changes in the convalescent stage of Vogt-Koyanagi-Harada disease (VKH). Macular spectral domain optical coherence tomography (SD-OCT) images of 22 eyes of 13 consecutive patients with VKH at the convalescent stage were compared to 17 eyes of 9 age/sex/refraction-matched normal subjects. The choriocapillaris layer, medium choroidal vessels (Sattler's layer), and large choroidal vessels (Haller's layer) were assessed in foveal SD-OCT scans. The presence and the extent of disruption of outer retinal structures were also noted. Inner and outer choroid boundaries were manually drawn on horizontal raster SD-OCT scans, and choroidal thickness and volume maps were generated. Correlation analysis was run to assess the association of the above parameters in the VKH patients compared to the normal subjects. In the eyes with convalescent stage of VKH, mean choroidal thickness in the foveal central subfield (200 +/- 60 mum) was lower than in matched controls (288 +/- 40 mum) (P < 0.0001). A thinner sub-macular choroid correlated with a lower visual acuity in uveitis eyes (Pearson correlation, r = -0.5089, P = 0.005). While the choriocapillaris layer was continuous and intact in all control eyes, various degrees of choriocapillaris loss were observed in 11 eyes (50%) with VKH (P < 0.0001). In these patients, the presence of outer retinal disruption was associated with a lower visual acuity (Spearman correlation, P < 0.001). The choroid is significantly thinner and the choriocapillaris layer is disrupted in the eyes with convalescent stage of VKH. Evaluation of the choriocapillaris in SD-OCT scans may be a useful surrogate marker for visual function in the convalescent stage of VKH.
    Journal of Ophthalmic Inflammation and Infection 03/2014; 4(1):9. DOI:10.1186/1869-5760-4-9
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    ABSTRACT: Purpose: To assess the change in subfoveal choroidal thickness (SFCT) in central serous chorioretinopathy (CSC) following spontaneous resolution and low-fluence photodynamic therapy (PDT) using the enhanced depth imaging optical coherence tomography (EDI-OCT). Methods: A total of 36 consecutive eyes of 36 patients were included in this retrospective study: 16 eyes with spontaneously resolved CSC and 20 eyes with PDT-treated CSC. Best-corrected visual acuity and SFCT were evaluated at each visit until complete absorption of the subretinal fluid. SFCT of 32 normal subjects were also measured, as the control group. Wilcoxon's singed-rank test was used to evaluate the effects of spontaneous resolution and PDT. To compare the SFCT of the eyes with resolved CSC with that of the normal eyes, Mann-Whitney U-test with Bonferroni correction was also employed. Results: SFCT of patients was 459.16±77.50 μm at the baseline, and decreased to 419.31±54.49μm after a spontaneous resolution (P=0.015). However, SFCT was not normalized in comparison with that of the normal subjects (P<0.001). SFCT in PDT group was also reduced from 416.43±74.01 to 349.50±88.99 μm (P<0.001), with no significant difference with the normal value (P=0.087). Conclusions: SFCT in patients with CSC decreased both after spontaneous resolution and low-fluence PDT. However, only in the PDT group, after disappearance of subretinal fluid, did it decrease to that of normal subjects.
    Eye (London, England) 01/2013; 27(3). DOI:10.1038/eye.2012.273 · 2.08 Impact Factor