Scleral Thickness in Steroid-Induced Central Serous Chorioretinopathy

Ophthalmol Sci. 2022 Feb 8;2(2):100124. doi: 10.1016/j.xops.2022.100124. eCollection 2022 Jun.

Abstract

Purpose: To evaluate and compare the scleral thickness of patients with idiopathic central serous chorioretinopathy (iCSC) and steroid-induced central serous chorioretinopathy (sCSC) using anterior-segment OCT.

Design: Retrospective, comparative study.

Participants: One hundred ten eyes of 110 patients with central serous chorioretinopathy.

Methods: We classified the patients into iCSC and sCSC groups and compared age, sex, spherical equivalent, axial length, subfoveal choroidal thickness (SCT), and scleral thickness. We measured scleral thickness 6 mm posterior to the scleral spur in 4 directions.

Main outcome measure: Scleral thickness in sCSC eyes.

Results: We enrolled 96 and 14 eyes in the iCSC and sCSC groups, respectively. The sCSC group included a greater proportion of women than the iCSC group (42.9% and 13.5%, respectively; P = 0.020). We observed no between-group differences in age, spherical equivalent, axial length, or SCT. Univariate analysis revealed that the sCSC group had a significantly thinner sclera at the superior (423.4 μm vs. 346.6 μm; P < 0.001), temporal (440.1 μm vs. 399.4 μm; P = 0.020), inferior (450.1 μm vs. 395.3 μm; P = 0.001), and nasal (436.6 μm vs. 391.9 μm; P = 0.002) points than the iCSC group. Multivariate analyses revealed that female sex (odds ratio, 4.322; 95% confidence interval, 1.025-18.224; P = 0.046) and mean scleral thickness (odds ratio, 0.972; 95% confidence interval, 0.955-0.990; P = 0.002) were significantly associated with sCSC.

Conclusions: The scleral thickness of eyes in the sCSC group was significantly thinner than that in the iCSC group. This suggests that the sclera has less involvement in the pathogenesis of sCSC than in that of iCSC.

Keywords: AS, anterior-segment; CSC, central serous chorioretinopathy; Central serous chorioretinopathy; Choroidal thickness; ICGA, indocyanine green angiography; Pachychoroid; SCT, subfoveal choroidal thickness; Scleral thickness; Steroid; iCSC, idiopathic central serous chorioretinopathy; sCSC, steroid-induced central serous chorioretinopathy.