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Terao N, Imanaga N, Wakugawa S, Sawaguchi S, Tamashiro T, Yamauchi Y, Koizumi H. CILIOCHOROIDAL EFFUSION IN CENTRAL SEROUS CHORIORETINOPATHY. Retina 2022; 42:730-737. [PMID: 34907128 PMCID: PMC8946592 DOI: 10.1097/iae.0000000000003376] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the prevalence of ciliochoroidal effusion (CE) in central serous chorioretinopathy (CSC) using anterior-segment optical coherence tomography and its association with the clinical features of CSC. METHODS Overall, 164 eyes of 164 patients with CSC and 51 eyes of 51 age- and sex-matched normal control participants were retrospectively examined. Anterior-segment optical coherence tomography was used to assess patients with CSC and control subjects for CE and scleral thickness. Central serous chorioretinopathy eyes were divided into two groups: eyes with CE (CE group) and eyes without CE (non-CE group). Scleral thickness was measured at the point that was 6 mm posterior to the scleral spur in four directions. RESULTS Among the 164 eyes with CSC, 32 eyes (19.5%) displayed CE, and this proportion was significantly higher than that in control subjects (2.0%) (P = 0.001). Scleral thickness was significantly greater in the CE group compared with the non-CE group at all four directions (P < 0.05 for all). Multivariable analysis revealed that the mean scleral thickness (odds ratio: 1.01; 95% confidence interval: 1.00-1.02; P = 0.007) was significantly associated with the incidence of CE. CONCLUSION Central serous chorioretinopathy may accompany fluid accumulation in the anterior segment more frequently than previously expected in association with thick sclera.
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Affiliation(s)
- Nobuhiro Terao
- Department of Ophthalmology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
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Onoe H, Shimada H, Kawamura A, Hirosawa H, Tanaka K, Mori R, Nakashizuka H. Bilateral Pachychoroid disease with type 3 Uveal effusion syndrome in one eye and central serous Chorioretinopathy in contralateral eye: a case report. BMC Ophthalmol 2022; 22:91. [PMID: 35197001 PMCID: PMC8867759 DOI: 10.1186/s12886-022-02316-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 02/16/2022] [Indexed: 11/12/2022] Open
Abstract
Background We report a case of bilateral pachychoroid disease with type 3 uveal effusion syndrome (UES) in one eye and central serous chorioretinopathy (CSC) in the contralateral eye. Case presentation A 65-year-old man presented to our department because of decreased vision. Visual acuity was 16/20 in the right eye and 2/20 in the left eye, with normal axial lengths. The left eye was diagnosed with CSC and underwent photocoagulation 8 years ago. The right eye showed inferior non-rhegmatogenous retinal detachment and peripheral choroidal detachment. Macular optical coherence tomography showed submacular fluid in the right eye, pachychoroid in both eyes, and choroidal thickness of 565 μm in the right and 545 μm in the left eye. In both eyes, fluorescence angiography showed window defects and mild fluorescence leakage, and indocyanine green angiography showed dilated choroidal vessels, mild choroidal hyperpermeability, and mild dye leakage. The left eye was diagnosed with chronic CSC. Initially, chronic CSC was also suspected in the right eye. However, photodynamic therapy failed, with worsened retinal detachment and visual acuity. Pachychoroid in the peripheral fundus (choroidal thickness 820 μm) was observed only in the right eye. Based on these findings, UES was diagnosed in the right eye. Sclerectomies were performed. The absence of scleral thickening and glycosaminoglycan deposition led to a final diagnosis of type 3 UES. The procedure was not effective, due to connective tissue regeneration at the sclerectomy sites. In the revision surgery, mitomycin-C was used with sclerectomies. One month after surgery, retinal and choroidal detachment disappeared, visual acuity recovered to 8/20, pachychoroid in the macula and peripheral fundus decreased, and choroidal thickness decreased to 352 μm in the macula and 554 μm in inferior peripheral fundus. Conclusions Pachychoroid in the posterior pole was the common finding in type 3 UES and CSC, although extensive pachychoroid in the peripheral fundus may have caused retinal and choroidal detachment in the eye with type 3 UES. Full-thickness sclerectomies with mitomycin-C improved pachychoroid in the peripheral fundus and resolved retinal and choroidal detachment, clearly indicating that the sclera was the main cause of type 3 UES.
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Affiliation(s)
- Hajime Onoe
- Department of Ophthalmology, School of Medicine, Nihon University Hospital, 1-6 Surugadai, Kanda, Chiyodaku, Tokyo, 101-8309, Japan
| | - Hiroyuki Shimada
- Department of Ophthalmology, School of Medicine, Nihon University Hospital, 1-6 Surugadai, Kanda, Chiyodaku, Tokyo, 101-8309, Japan.
| | - Akiyuki Kawamura
- Department of Ophthalmology, School of Medicine, Nihon University Hospital, 1-6 Surugadai, Kanda, Chiyodaku, Tokyo, 101-8309, Japan
| | - Hiromi Hirosawa
- Department of Ophthalmology, School of Medicine, Nihon University Hospital, 1-6 Surugadai, Kanda, Chiyodaku, Tokyo, 101-8309, Japan
| | - Koji Tanaka
- Department of Ophthalmology, School of Medicine, Nihon University Hospital, 1-6 Surugadai, Kanda, Chiyodaku, Tokyo, 101-8309, Japan
| | - Ryusaburo Mori
- Department of Ophthalmology, School of Medicine, Nihon University Hospital, 1-6 Surugadai, Kanda, Chiyodaku, Tokyo, 101-8309, Japan
| | - Hiroyuki Nakashizuka
- Department of Ophthalmology, School of Medicine, Nihon University Hospital, 1-6 Surugadai, Kanda, Chiyodaku, Tokyo, 101-8309, Japan
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