Anterior uveal morphometrics in complex central serous chorioretinopathy: insights from ultrasound biomicroscopy and anterior segment optical coherence tomography.

CLINICAL RELEVANCE: Anterior segment morphometric parameters, including the iris, ciliary body, ciliary process and anterior sclera, re ect uveal vascular physiology and scleral biomechanics. These structures may help clinicians better understand disorders associated with altered ocular uid dynamics within the pachychoroid spectrum.

BACKGROUND

Complex central serous chorioretinopathy is characterised by serous neurosensory retinal detachment and is commonly associated with pachychoroid features, including increased subfoveal choroidal thickness. However, the potential contribution of anterior uveal and scleral structures to its pathophysiology remains insu ciently de ned.

METHODS

This study included 32 eyes with active complex central serous chorioretinopathy and 31 age- and gender-matched controls. Iris, ciliary body, and ciliary process thicknesses were measured using ultrasound biomicroscopy under standardised photo-pic conditions. Anterior scleral thickness was measured at 1, 2 and 3 mm posterior to the scleral spur using anterior segment optical coherence tomography. Subfoveal choroidal and central macular thickness were measured by spectral-domain optical coherence tomography. Correlations were analysed with false discovery rate correction.

RESULTS

Ciliary body (0.93 ± 0.11 mm vs 0.78 ± 0.10 mm) and anterior scleral thickness (0.57 ± 0.06 mm vs 0.49 ± 0.05 mm) were signi cantly greater in complex disease than in controls (both p < 0.001). Subfoveal choroidal thickness (425.7 ± 83.8 µm vs 290.7 ± 68.5 µm) and central macular thickness (330.7 ± 74.0 µm vs 226.5 ± 18.8 µm) were also higher (p < 0.001). Anterior scleral thickness correlated with ciliary body (r = 0.494), ciliary process (r = 0.498) and subfoveal choroidal thickness (r = 0.509) (all p < 0.001). Temporal iris thickness correlated with temporal anterior scleral thickness (rs = 0.410; p = 0.006).

CONCLUSION

Active complex disease is associated with increased anterior uveal and scleral thickness, suggesting anterior segment involvement parallel to posterior pachychoroid changes.