Changes in choroidal vessel morphology associated with fluid leakage in central serous chorioretinopathy; a comparison of OCTA and ICGA.

PURPOSE: To identify changes in choroidal morphology crucial for CSCR this study assessed the relationship between pachychoroidal changes and the occurrence of CSCR. Additionally, given the undefined role of optical coherence tomography angiography (OCTA) in CSCR diagnosis, this study evaluated OCTA as an alternative to indocyanine green angiography (ICGA).

METHODS

Multimodal imaging of 99 patients affected by unilateral or bilateral CSCR was retrospectively assessed to identify pachychoroidal changes. Through logistic regression the relationship between these choroidal changes and CSCR occurrence was examined. Evaluation of ICGA and OCTA images was conducted separately, followed by a comparative analysis of the obtained results.

RESULTS

Presence of intervortex venous anastomoses significantly increased the likelihood of CSCR affection (P = 0.0004, odds ratio 4.829), whereas presence of pachyvessels did not (P = 0.7947). Comparative evaluation of pachychoroidal changes between OCTA and ICGA images resulted in 95.16% of cases in coinciding results. OCTA images exhibited less impairment in quality due to subretinal fluid than ICGA images.

CONCLUSION

Intervortex venous anastomoses were significantly associated with the presence of subretinal fluid and serous pigment epithelium detachment; however, longitudinal studies are required to establish a causal relationship. OCTA has emerged as a non-invasive alternative to ICGA to assess pachychoroidal changes in patients with CSCR.