Objective: To analyze the characteristics of the retrobulbar blood vessels' hemodynamics changes and the choroidal circulation disorder, and to observe the relations between retinal pigment epithelium's (RPE) pathological changes and them.
Methods: It was a case control study. For 57 (57 affected eyes and 57 contralateral eyes) unilateral eye affected patients and 25 (50 eyes) normal health adults, we examined ophthalmic arteries (OA), posterior ciliary arteries (PCA) and short posterior ciliary arteries (SPCA) by color Doppler flow Imaging (CDFI), and recorded the peak systolic velocities (PSV), end diastolic velocities (EDV) and resistance indexes (RI) of them. We compared each hemodynamic parameter of the normal eyes with it of the affected eyes and contralateral eyes in patients group respectively, and contrasted them between affected eyes and contralateral eyes of the patients. Fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed simultaneously on 57 patients with Heidelberg retina angiography, and the images were analyzed in contrast. We used SPSS 12.0 statistics software was used in the study. To the PSV, EDV and RI of the OA, PCA and SPCA in affected eyes and contralateral eyes of the patients, we used paired t-test for the same sample to compare their hemodynamic parameters; to compare normal health adults' eyes with the affected eyes and the contralateral eyes of patients group respectively, we used two-group t-test. When the P-value was less than 0.05, there was a statistical significance.
Results: There was a more significant decrease of the hemodynamic parameters in both PSVs and EDVs of temporal PCAs (PSV: t = 3.044, P = 0.005; EDV: t = 3.731, P = 0.001) and temporal SPCAs (PSV: t = 2.822, P = 0.008; EDV: t = 3.194, P = 0.003) compared the patients group's affected eyes with normal health adults group eyes, there was a more significant decrease of them of temporal PCAs (PSV: t = 3.219, P = 0.003; EDV: t = 3.807, P = 0.001) and temporal SPCAs (PSV: t = 3.931, P = 0.000, EDV: t = 3.145, P = 0.003) compared the patients group's contralateral eyes with normal health adults group eyes, and there was a statistical significance of them (P < 0.05). There was no difference in hemodynamic parameters of both PSVs and EDVs of temporal PCAs (PSV: t = 0.608, P = 0.548; EDV: t = 0.122, P = 0.904) and temporal SPCAs (PSV: t = 0.730, P = 0.470; EDV: t = 0.109, P = 0.914) between affected eyes and contralateral eyes of the patients, and there was no statistical significance of them (P > 0.05). The results of FFA and ICGA showed that all the RPE's leaks of 57 affected eyes appeared at the hypofluorescent regions of relative choroids; 52 cases of 57 affected eyes were followed by choroidal vessels dilatation at the early hypofluorescent regions, and appeared hyperfluorescence leakages in the late phase images; At the all regions of RPE's transmitted fluorescences of affected eyes and contralateral eyes, the corresponding choroids showed hyperfluorescence in the late phase images in ICGA; There were no RPE's transmitted fluorescences at the regions of 20 affected eyes and 16 contralateral eyes in FFA, which showed hyperfluoresceince leakages in the late phase images of choroids in ICGA.
Conclusions: CSC is possibly a bilateral disease associated with systemic pathologic conditions. Hypoperfusion and ischemia are the basal characteristics of retrobulbar blood vessels' circulation disorder and choroidal ultracirculation disorder. The damage of RPE is following to the choroidal circulation disorder.