Quantitative Optical Coherence Tomography Angiography of Retinal and Choriocapillaris Microvasculature in Central Serous Chorioretinopathy

Objective: We aimed to quantitatively evaluate choriocapillaris (CC) patterns in central serous chorioretinopathy (CSC) using optical coherence tomography angiography (OCTA).Methods: Macular OCTA images (6 × 6 mm) were acquired using the RTVue-XR Avanti with the AngioVue imaging system (Luneau Technology, Pont-de-l'Arche, France).Quantitative analysis of the superficial and deep retinal capillary plexuses and CC was performed using en face projection images.Evaluated parameters included vessel density, fractal dimension, and the area and density of CC flow deficits.Results: Forty-seven patients diagnosed with CSC (56 affected eyes and 38 fellow eyes) were included.Abnormal OCTA features were observed in 49 (87.5%)affected eyes and 14 (36.8%)fellow eyes (p < 0.001).Dark areas were seen in 28 (50.0%)affected eyes and eight (21.1%)fellow eyes, respectively (p = 0.002), and dark spots were noted in 20 (35.7%) affected eyes and four (10.5%) fellow eyes, respectively (p = 0.002); abnormal vessels were observed in 10 (17.9%) affected eyes and two (5.3%) fellow eyes, respectively (p = 0.045).Affected eyes showed significantly lower CC flow deficit (mean difference -1.94, p = 0.019) and CC flow area (mean difference -0.24, p < 0.001) compared to fellow eyes.No significant differences (p > 0.05) were observed in outer retinal flow area, subfoveal choroidal thickness, or choroidal vascularity index.Conclusion: OCTA showed that eyes with CSC frequently exhibit dark areas and dark spots, along with significantly lower CC flow deficit (P=0.019) and reduced CC flow area (P <0.001) compared with fellow eyes.These findings suggest that OCTA provides valuable insights into CC alterations and the pathogenesis of CSC.