Japanese journal of ophthalmology · 2026
Evaluation of anterior scleral thickness in pachychoroid pigment epitheliopathy, central serous chorioretinopathy and pachychoroid neovasculopathy.
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Şahin Şekerci Arzu Nur, Atalay Ali Şemsi, Cankı Enise Kübra, Koca Semra
Аннотация
PURPOSE: To compare anterior scleral thickness (AST) among pachychoroid pigment epitheliopathy (PPE), central serous chorioretinopathy (CSC), pachychoroid neovasculopathy (PNV) and healthy controls.
STUDY DESIGN: Retrospective cross-sectional study.
METHODS: This single-center, retrospective cross-sectional study included 73 eyes of 72 patients with pachychoroid spectrum disease (PPE (n = 35), CSC (n = 25), PNV (n = 12)) and 29 control eyes. All participants underwent comprehensive ophthalmic examination and swept-source optic coherence tomography (OCT) (Topcon DRI-OCT Triton). Choroidal thickness (CT) was measured subfoveally, at 500 and 1000 μm nasal/temporal to the fovea, and sublesionally. AST was measured with the anterior segment mode 6 mm posterior to the scleral spur in four quadrants.
RESULTS: CT was significantly greater in CSC than in PPE, PNV, and controls at all macular locations (all p < 0.001). Sublesional CT differed among pachychoroid groups (p = 0.005), with CSC thicker than PPE (p = 0.002) and PNV (p = 0.011); PPE and PNV did not differ (p = 1.000). Anterior scleral thickness was significantly greater in all quadrants in the pachychoroid groups compared with controls (p < 0.001). Superior AST was greater in PPE than PNV (p = 0.044); other inter-pachychoroid comparisons were not significant (p > 0.05). In multivariate linear regression model, the presence of pachychoroid spectrum disease was independently associated with thicker AST after adjustment for age, sex, AXL, and SE (p< 0.001 for all quadrants).
CONCLUSION: Eyes with pachychoroid spectrum disease exhibit increased AST relative to controls, while diffuse CT thickening is most pronounced in CSC. These findings support a pathophysiologic association between scleral structure and choroidal venous overload in pachychoroid disorders and highlight AST as a potential structural biomarker.
STUDY DESIGN: Retrospective cross-sectional study.
METHODS: This single-center, retrospective cross-sectional study included 73 eyes of 72 patients with pachychoroid spectrum disease (PPE (n = 35), CSC (n = 25), PNV (n = 12)) and 29 control eyes. All participants underwent comprehensive ophthalmic examination and swept-source optic coherence tomography (OCT) (Topcon DRI-OCT Triton). Choroidal thickness (CT) was measured subfoveally, at 500 and 1000 μm nasal/temporal to the fovea, and sublesionally. AST was measured with the anterior segment mode 6 mm posterior to the scleral spur in four quadrants.
RESULTS: CT was significantly greater in CSC than in PPE, PNV, and controls at all macular locations (all p < 0.001). Sublesional CT differed among pachychoroid groups (p = 0.005), with CSC thicker than PPE (p = 0.002) and PNV (p = 0.011); PPE and PNV did not differ (p = 1.000). Anterior scleral thickness was significantly greater in all quadrants in the pachychoroid groups compared with controls (p < 0.001). Superior AST was greater in PPE than PNV (p = 0.044); other inter-pachychoroid comparisons were not significant (p > 0.05). In multivariate linear regression model, the presence of pachychoroid spectrum disease was independently associated with thicker AST after adjustment for age, sex, AXL, and SE (p< 0.001 for all quadrants).
CONCLUSION: Eyes with pachychoroid spectrum disease exhibit increased AST relative to controls, while diffuse CT thickening is most pronounced in CSC. These findings support a pathophysiologic association between scleral structure and choroidal venous overload in pachychoroid disorders and highlight AST as a potential structural biomarker.