Reduction in choroidal thickness associated with the progression of pachychoroid spectrum diseases

Area of Science:

• Ophthalmology
• Retinal Diseases
• Choroidal Imaging

Background:

• Pachychoroid spectrum diseases, including central serous chorioretinopathy (CSC), pachychoroid neovasculopathy (PNV), and polypoidal choroidal vasculopathy (PCV), are characterized by distinct choroidal changes.
• Understanding the progression and comparative choroidal morphology is crucial for diagnosis and management.

Purpose of the Study:

• To compare choroidal thicknesses in macular and peripheral areas among eyes with CSC, PNV, and PCV.
• To evaluate these thicknesses against normal control eyes.

Main Methods:

• A retrospective case-control study involving 117 eyes with treatment-naïve pachychoroid spectrum diseases (52 CSC, 27 PNV, 38 PCV) and 106 matched controls.
• Quantitative analysis of widefield choroidal thickness maps generated by widefield optical coherence tomography.
• Determination and comparison of mean choroidal thickness in macular and four peripheral areas.

Main Results:

• Mean choroidal thickness decreased progressively from CSC to PNV and PCV across all measured areas, with significant differences between CSC and the other two conditions.
• The reduction in choroidal thickness with aging was greater in pachychoroid spectrum diseases than in normal controls.
• No significant difference in mean choroidal thickness was found between PNV and PCV.

Conclusions:

• Choroidal thickness generally decreases with the progression of pachychoroid spectrum diseases.
• This decline may be linked to reduced choroidal blood flow and choriocapillaris attenuation, influenced by aging and the underlying pachychoroid pathophysiology.