Assessment of choroidal topographic changes by swept source optical coherence tomography after photodynamic therapy for central serous chorioretinopathy – Accepted Manuscript

Abstract: Purpose: To investigate the relationship between choroidal thickness and angiographic abnormalities in central serous chorioretinopathy (CSC) eyes by swept-source optical coherence tomography (Swept-OCT), before and after half-fluence photodynamic therapy (PDT).Design: Prospective interventional case series.Methods: Consecutive patients presenting with treatment-naïve active CSC underwent a complete ophthalmologic examination, including Swept-OCT at study entry, and 7 days and 30 days after treatment with half-fluence PDT. Main outcome measures were changes in choroidal maps after PDT (mean±SD) and the relationship between choroidal thickness and angiographic abnormalities.Results: Twelve eyes of 12 patients (2 females, 10 males; mean age 55.6±14.0 years) were included. At study entry, mean choroidal thickness measured in the center of the fovea was significantly thicker in the study eyes as compared to the fellow eyes (420.7±107.5 μm vs 349.2±109.7 μm, respectively; p=0.016). Mean choroidal thickness in the center of the fovea significantly decreased in the study eyes at both 7 days (380.2±113 μm; p=0.005) and 30 days after PDT (362.3±111 μm; p=0.002). A similar significant choroidal thinning was recorded in each ETDRS applied to 3D Swept-OCT maps. At each time-point, mean choroidal thickness was significantly thicker in sectors with than without angiographic abnormalities (421±102.4 μm vs. 397.6±96.5 μm, p=0.002 at study entry; 381.2±106.6 μm vs. 364±101.2 μm, p=0.01 at day-7; 366.3±103.2 μm vs. 347.2±99.6 μm at day-30).Conclusions: Using Swept-OCT we demonstrated that in active CSC, choroidal thickness is increased to a greater extent in areas characterized by angiographic abnormalities. This increased choroidal thickness may persist even after PDT.