Short Axial Length Is Related to Asymmetric Vortex Veins in Central Serous Chorioretinopathy

Ophthalmol Sci. 2021 Oct 26;1(4):100071. doi: 10.1016/j.xops.2021.100071. eCollection 2021 Dec.

Abstract

Purpose: To investigate the clinical and morphologic factors related to asymmetric dilated vortex veins in central serous chorioretinopathy (CSC).

Design: Retrospective, comparative study.

Participants: One hundred fifty-eight eyes of 158 patients with CSC.

Methods: All patients with CSC underwent ophthalmic examination and multimodal imaging, including measurements of axial length (AL), fluorescein angiography, indocyanine green angiography, swept-source OCT, and anterior segment OCT. Using en face OCT images at the level of the outer choroid, the eyes were divided into 2 groups: eyes with symmetric vortex veins (symmetry group) and those with asymmetric vortex veins (asymmetry group).

Main outcome measures: Clinical and morphologic factors related to asymmetric vortex veins in CSC.

Results: Of the 158 eyes, 120 eyes (75.9%) were classified into the asymmetry group and 38 eyes (24.1%) were classified into the symmetry group. The asymmetry group showed significantly greater spherical equivalent (-0.32 ± 1.78 diopters [D] vs. -1.35 ± 2.64 D; P = 0.033), shorter AL (23.52 ± 0.86 mm vs. 24.10 ± 1.06 mm; P = 0.005), and greater subfoveal choroidal thickness (414.6 ± 105.3 μm vs. 360.4 ± 91.8 μm; P = 0.005) than the symmetry group. No significant differences existed between the 2 groups regarding age, sex, or all scleral thicknesses at the superior, temporal, inferior, and nasal points. In the multivariate analyses, shorter AL (odds ratio, 0.56; 95% confidence interval, 0.36-0.88; P = 0.011) was found to be significantly associated with the presence of asymmetric vortex veins.

Conclusions: The asymmetric dilated vortex vein is a common finding in patients with CSC. Our results suggest that certain biometric factors, such as short AL, may be associated with asymmetric dilated vortex veins developing in patients with CSC.

Keywords: AL, axial length; AS, anterior-segment; Asymmetric dilated vortex vein; Axial length; CSC, central serous chorioretinopathy; Central serous chorioretinopathy; Choroidal thickness; Choroidal vascular hyperpermeability; D, diopter; ICGA, indocyanine green angiography; Pachychoroid; SCT, subfoveal choroidal thickness; SE, spherical equivalent; SRD, serous retinal detachment; SS, swept-source; Scleral thickness.