CHOROIDAL CAPILLARY AND VENOUS CONGESTION IN CENTRAL SEROUS CHORIORETINOPATHY

PURPOSE: Abnormalities in choroidal perfusion have been hypothesized t o be causative factors in central serous chorioretinopathy. This prosp ective study was performed to evaluate changes in the choroidal circul ation in cases of central serous chorioretinopathy. METHODS: In 32 con secutive patients with acute or chronic recurrent central serous chori oretinopathy, complete clinical ophthalmologic examinations, fluoresce in angiography, and indocyanine green angiography with a scanning lase r ophthalmoscope and a digital imaging system were performed. RESULTS: All patients with acute and chronic recurrent central serous choriore tinopathy dem onstrated a localized delay in arterial filling followed by choroidal hyperperfusion in the area of the damaged retinal pigmen t epithelium, frequently associated with dilated capillaries and dilat ed draining venules in one or more choroidal lobules. These changes co rresponded to areas with pigment epithelial detachment or focal leakag e from the retinal pigment epithelium found in fluorescein angiography . Furthermore, in some patients, localized choroidal ischemia could be observed in additional areas throughout the central fundus in both di seased eyes and normal fellow eyes. CONCLUSIONS: Delayed arterial fill ing followed by capillary and venous hyperemia, angiographically appea ring as capillary and venous congestion, can be observed frequently in eyes with central serous chorioretinopathy. The results suggested tha t capillary or venous congestion after ischemia in one or more choroid al lobules might be the reason for the choroidal hyperpermeability ass ociated with central serous chorioretinopathy.