Acute Central Serous Choricoretinopathy and Choroidal Circulatory Changew: Indocyanine Green Angiographic Findings.

Kim, Pyeong Sik; Lee, Won Ki; Kim, Ha Kyoung

Original Article

Journal of the Korean Ophthalmological Society 1998;39(10):2366-2376.
Published online October 1, 1998.

Acute Central Serous Choricoretinopathy and Choroidal Circulatory Changew: Indocyanine Green Angiographic Findings.

Pyeong Sik Kim, Won Ki Lee, Ha Kyoung Kim

Department of Ophthalmology, Knagmam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea.

"급성 중심성장액맥락망막병증과 맥락막순환 변화 ; 인도시아닌그린 형광안저촬영 소견 "

김평식(Pyeong Sik Kim),이원기(Won Ki Lee),김하경(Ha Kyoung Kim)

Abstract

We performed indocyanine green angiography(ICGA) in 21 eyes of 21 patients with acute central serous chorioretinopathy(CSC) to investigate choroidal cirulatory changes in this disease. Heidelberg retina angiograph (HRA) that using confocal scanning laser ophthalmoscope was used for ICGA. In the very early phase of HRA, 19 eyes(90%) demonstrated focal areas of delayed filling usually followed by distinctively fluorescent, dilated choroidal vessels running through or around these areas. After mid-phase, diffuse intrachoroidal hyperfluorescence surrounding these dilated vessels and suggesting increased leakage from them was seen in 19 eyes(90%). The focal delays of choroidal filling seemed to reveal choroidal ischemia involved in this disease process rather than physiological delays as they were topographically associated with choroidal hyperfluorescence in the later phase of HRA and leaking points on fluoresecein angiogram. Based on these findings, we suggest the choroid as the primary pathologic focus of acute CSC. Also we propose a scenario of pathogenesis, beginning with choroidal ischemia that leads to increased leakage from choroidal vessels, secondary changes of retinal pigment epithelium and passage of fluid in the subretinal space.

Key Words: Acute central serous chorioretinopathy;Choroidal ischemia;HRA;Increased leakage;Retinal pigment epithelium