Choroidal Vascularity Index in Central Serous Chorioretinopathy

Abstract

Increased CVI suggests increased vascular component compared with the stromal component in acute CSC. Increased CVI was noted in fellow eye of the subjects with acute CSC in comparison with age-matched healthy subjects. The CVI could be a useful index for early diagnosis of CSC and to assess the treatment response after laser photocoagulation or photodynamic therapy.

The comparison of multimodal imaging findings of central serous chorioretinopathy patients in regard to the early anatomically treatment response to half-fluence photodynamic therapy: a retrospective case–control study

“…Indeed, this finding was not surprising considering the pathogenesis of CSC [13–17]. The intense hypercyanescence at the midphase ICGA is usually secondary to engorged leaking choroidal vessels, and PDT causes a decrease in the leakage from and thinning of the choroid [3, 5, 13]. Our results support all of these mechanism.…”

“…Two theories have been proposed regarding the pathophysiology of CSC which are based either on choroidal dysfunction or retinal pigment epithelium (RPE) dysfunction, respectively. Although RPE dysfunction theory has yielded more attention for a long time, choroidal thickness theory has become more important after the results of indocyanine green angiography (ICGA) and enhanced depth imaging optical coherence tomography (EDI-OCT) studies [3–5]. In CSC patients, choroidal vascular anomalies and leakage was shown via ICGA, and subfoveal choroidal thickness was found to be thicker via EDI-OCT, two essential findings supporting further the role of choroidal dysfunction in the pathogenesis [3–5].…”

“…Although RPE dysfunction theory has yielded more attention for a long time, choroidal thickness theory has become more important after the results of indocyanine green angiography (ICGA) and enhanced depth imaging optical coherence tomography (EDI-OCT) studies [3–5]. In CSC patients, choroidal vascular anomalies and leakage was shown via ICGA, and subfoveal choroidal thickness was found to be thicker via EDI-OCT, two essential findings supporting further the role of choroidal dysfunction in the pathogenesis [3–5]. On the other hand, taking into account the important role that a normal functioning RPE plays by quickly absorbing the subretinal fluid (SRF), it is not possible to completely exclude the RPE theory from the pathogenesis.…”

Comparison of Choroidal Vascularity Markers on Optical Coherence Tomography Using Two-Image Binarization Techniques

“…CVI but not CT, was shown to be independent from systemic and ocular factors such as age, axial length, intraocular pressure, or systolic blood pressure in a large study involving 345 normal subjects. 20 In eyes from diabetic patients and eyes with exudative AMD, there were decreased CVI with no significant change in CT. 26,28,29 CVI was also shown to provide additional information to CT in terms of longitudinal choroidal structural changes in diseases such as panuveitis 20 ; Vogt-Koyanagi-Harada (VKH) disease 25 ; central serous chorioretinopathy (CSCR) 24 ; and myopic choroidal neovascularization. 27 Changes in L/C ratio or a similar index called L/S ratio (ratio of choroidal luminal area to stromal area) were investigated and found to yield valuable information in normal physiologic conditions including diurnal variation 22 and dynamic exercise 23 as well as in a number of ocular diseases including exudative AMD 21 ; polypoidal choroidal vasculopathy (PCV) 34 ; CSCR 32,33 ; VKH disease 30,31 ; and retinitis pigmentosa.…”

“…It was termed ''choroidal vascularity index (CVI)'' by Agrawal et al 19 or ''luminal/choroidal area ratio (L/C ratio)'' by Sonoda et al 18 This new marker of choroidal vascularity has been investigated in normal physiologic conditions 18,[20][21][22][23] and also validated as a useful tool in various ocular diseases. 19,[24][25][26][27][28][29][30][31][32][33][34][35][36] Differences exist in the image binarization algorithms for the calculation of CVI and L/C ratio. 20 Although they are measuring the same entity, there is no direct head-to-head comparison between the two.…”