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Retinal and choroidal vasoreactivity in central serous chorioretinopathy

  • Retinal Disorders
  • Published:
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Abstract

Purpose

This study aims to investigate retinal and choroidal vascular reactivity to carbogen in central serous chorioretinopathy (CSC) patients.

Methods

An experimental pilot study including 68 eyes from 20 CSC patients and 14 age and sex-matched controls was performed. The participants inhaled carbogen (5% CO2 + 95% O2) for 2 min through a high-concentration disposable mask. A 30° disc-centered fundus imaging using infra-red (IR) and macular spectral domain optical coherence tomography (SD-OCT) using the enhanced depth imaging (EDI) technique was performed, both at baseline and after a 2-min gas exposure. A parametric model fitting-based approach for automatic retinal blood vessel caliber estimation was used to assess the mean variation in both arterial and venous vasculature. Choroidal thickness was measured in two different ways: the subfoveal choroidal thickness (SFCT) was calculated using a manual caliper and the mean central choroidal thickness (MCCT) was assessed using an automatic software.

Results

No significant differences were detected in baseline hemodynamic parameters between both groups. A significant positive correlation was found between the participants’ age and arterial diameter variation (p < 0.001, r = 0.447), meaning that younger participants presented a more vasoconstrictive response (negative variation) than older ones. No significant differences were detected in the vasoreactive response between CSC and controls for both arterial and venous vessels (p = 0.63 and p = 0.85, respectively). Although the vascular reactivity was not related to the activity of CSC, it was related to the time of disease, for both the arterial (p = 0.02, r = 0.381) and venous (p = 0.001, r = 0.530) beds. SFCT and MCCT were highly correlated (r = 0.830, p < 0.001). Both SFCT and MCCT significantly increased in CSC patients (p < 0.001 and p < 0.001) but not in controls (p = 0.059 and 0.247). A significant negative correlation between CSC patients’ age and MCCT variation (r =  − 0.340, p = 0.049) was detected. In CSC patients, the choroidal thickness variation was not related to the activity state, time of disease, or previous photodynamic treatment.

Conclusion

Vasoreactivity to carbogen was similar in the retinal vessels but significantly higher in the choroidal vessels of CSC patients when compared to controls, strengthening the hypothesis of a choroidal regulation dysfunction in this pathology.

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Acknowledgements

We thank Professor Dr. Pedro Castro (Neurology Department, Centro Hospitalar Universitário de São João, E.P.E., Porto; Faculty of Medicine of University of Porto, Portugal) for his most valuable contribution and mentorship in methodology. We thank Professor Dr. Patrício Costa (Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal) for his contribution in statistical analysis.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Ophthalmology Department, Centro Hospitalar Universitário de São João, E.P.E., Alameda Professor Hernâni Monteiro, Porto, Portugal

    Susana Penas, Maria Lurdes Martins, Vânia Sousa, Amândio Rocha-Sousa, Ângela Carneiro & Fernando Falcão-Reis

  2. Faculty of Medicine, University of Porto, Porto, Portugal

    Susana Penas, Amândio Rocha-Sousa, Ângela Carneiro & Fernando Falcão-Reis

  3. INESC TEC – Institute for Systems and Computer Engineering, Technology and Science, Porto, Portugal

    Teresa Araújo, Ana Maria Mendonça, Simão Faria, Jorge Silva & Aurélio Campilho

  4. Faculty of Engineering, University of Porto, Porto, Portugal

    Teresa Araújo, Ana Maria Mendonça, Simão Faria, Jorge Silva & Aurélio Campilho

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  1. Susana Penas
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Correspondence to Susana Penas.

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A written consent was obtained for all the participants in this study.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee For Health From Centro Hospitalar Universitário de São João (project 52/2016), and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

S.P.: participation in advisory boards for Alimera, Bayer, Novartis, Roche. A.C.: participation in advisory boards for Allergan, Alimera, Bayer, Novartis, and Roche. All the other authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

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Penas, S., Araújo, T., Mendonça, A.M. et al. Retinal and choroidal vasoreactivity in central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol 260, 3825–3836 (2022). https://doi.org/10.1007/s00417-022-05757-9

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