Retinal Vascular Reactivity in Central Serous Chorioretinopathy

Piccolino, Felice Cardillo; Lupidi, Marco; Cagini, Carlo; Fruttini, Daniela; Nicolò, Massimo; Eandi, Chiara M; Tito, Silvia

doi:10.1167/iovs.18-24475

Cited by 13 publications

(6 citation statements)

References 34 publications

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“…This study also showed that under exertion, patients with CSC have significantly increased blood flow compared to that of healthy subjects (Cardillo Piccolino et al. 2018). Another study of the retinal vessels in patients with CSC using dynamic vessel analysis showed a reduced dilation of the venous vessels to a flicker stimulus, the authors speculated that increased sympathetic tone may be responsible for this (Tomasso et al.…”

Section: Introductionmentioning

confidence: 65%

Patients with central serous chorioretinopathy not only have pachychoroidal disorders but also altered retinal metabolic function

Tschuppert

Valmaggia

Todorova

2022

Acta Ophthalmologica

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Purpose: The aim of our study was to compare metabolic (oxygen saturation; %) and anatomical (diameter; lm) retinal vessel parameters of patients with central serous chorioretinopathy (CSC) to those of controls. Methods: In this prospective cross-sectional cohort study, 72 eyes of patients with CSC were compared with 21 eyes of healthy controls. Of the 72 patients, 52 had chronic, nonactive CSC (subgroup nCSC) and 20 had active CSC (subgroup aCSC), according to activity on fluorescein angiography. Retinal vessel oximetry (RO) was performed using the Oxymap T1 oximeter. Oxygen saturation in all major peripapillary retinal arterioles (A-SO 2 ) and venules (V-SO 2 ) was measured, and their difference (A-V SO 2 ) was calculated. In addition, we evaluated the corresponding diameter in retinal arterioles (D-A) and venules (D-V). For statistical evaluation, ANOVA-based linear mixed-effects models were calculated (SPSSâ; p < 0.05). Results: Central serous chorioretinopathy (CSC) patients had significantly higher A-SO 2 and V-SO 2 compared to that of controls (p = 0.031 and p = 0.018 respectively). Especially, the subgroup of aCSC patients showed significantly higher A-SO 2 and V-SO 2 values (p = 0.027 and p = 0.034, respectively). In addition, superotemporal and superonasal quadrant location showed significant interactions with A-SO 2 and V-SO 2 (p ≤ 0.03). Diameter in retinal arterioles (D-A), an venules (D-V) and A-V SO 2 findings showed no significant differences (p > 0.096). Conclusion: These data indicate that patients with CSC have altered metabolic function. The presence of disease activity showed the greatest influence on RO measurement, both compared to controls and to those with inactive chronic CSC disease.

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Section: Introductionmentioning

confidence: 65%

Patients with central serous chorioretinopathy not only have pachychoroidal disorders but also altered retinal metabolic function

Tschuppert

Valmaggia

Todorova

2022

Acta Ophthalmologica

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“…There are many methods available to elicit a dynamic response in the retinal microvasculature. The handgrip test and hyperoxic conditions have been previously used to induce retinal vasoconstriction ( 27 , 30 , 51 , 52 ), while the flicker test and hypoxia have been reported to illicit a vasodilatory response ( 27 , 30 , 53 ). Currently, these techniques are limited to research use, however they may have clinical applicability with standardization of methods and reporting of test findings.…”

Section: Discussionmentioning

confidence: 99%

“…The hypoxia challenge test is standardized by the British Thoracic Society to assess whether individuals with stable respiratory disease are suitable for a long-haul flight by exposing them to reduced oxygen levels similar to those encountered in an airplane cabin ( 54 ). The handgrip test is used to assess cardiovascular autonomic function ( 42 ), and has been used for a wide variety of clinical indications ( 33 , 51 , 52 ). Despite their convenience, both tests have their limitations.…”

Section: Discussionmentioning

confidence: 99%

Retinal vascular reactivity in carriers of X-linked inherited retinal disease – a study using optical coherence tomography angiography

Gocuk,

Hadoux,

Catipon

et al. 2024

Front. Ophthalmol.

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PurposeFemale carriers of X-linked inherited retinal diseases (IRDs) can show highly variable phenotypes and disease progression. Vascular reactivity, a potential disease biomarker, has not been investigated in female IRD carriers. In this study, functional optical coherence tomography angiography (OCT-A) was used to dynamically assess the retinal microvasculature of X-linked IRD carriers.MethodsGenetically confirmed female carriers of IRDs (choroideremia or X-linked retinitis pigmentosa), and healthy women were recruited. Macular angiograms (3x3mm, Zeiss Plex Elite 9000) were obtained in 36 eyes of 15 X-linked IRD female carriers and 21 age-matched control women. Two tests were applied to test vascular reactivity: (i) mild hypoxia and (ii) handgrip test, to induce a vasodilatory or vasoconstrictive response, respectively. Changes to vessel density (VD) and vessel length density (VLD) were independently evaluated during each of the tests for both the superficial and deep capillary plexuses.ResultsIn the control group, the superficial and deep VD decreased during the handgrip test (p<0.001 and p=0.037, respectively). Mean superficial VLD also decreased during the handgrip test (p=0.025), while the deep plexus did not change significantly (p=0.108). During hypoxia, VD and VLD increased in the deep plexus (p=0.027 and p=0.052, respectively) but not in the superficial plexus. In carriers, the physiologic vascular responses seen in controls were not observed in either plexus during either test, with no difference in VD or VLD noted (all p>0.05).ConclusionsFunctional OCT-A is a useful tool to assess dynamic retinal microvascular changes. Subclinical impairment of the physiological vascular responses seen in carriers of X-linked IRDs may serve as a valuable clinical biomarker.

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“…Previous studies using OCTA reported contrasting results on the change of DCP density in CSC. Piccolino et al showed that DCP density was lower in CSC patients compared with healthy controls 14 , while Nelis et al showed that CSC patients had higher DCP density and larger FAZ area than did healthy controls 9 . In our study, CSC patients had a lower FCP density, smaller FAZ area, and higher DCP density than did healthy controls, albeit without statistical significance (Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

“…However, visual impairments may persist in some patients even after the dissipation of fluid, due to disruption of the retinal microarchitecture, subretinal fibrosis, and scarring or atrophy of the RPE 8 – 10 . There is still controversy among several studies using coherence tomography angiography (OCTA) whether the macular vascular alteration occurs at the early stage of CSC 9 , 11 – 14 . Thus, more sensitive and accurate imaging modalities are required for the early detection of changes in retinal blood flow.…”

Section: Introductionmentioning

confidence: 99%

Subretinal fluid disturbs the retinal venous blood flow in central serous chorioretinopathy

Lim

Moon

Lee

2022

Sci Rep

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The significance of subretinal fluid in the retinal blood flow is unclear. Here, we evaluated the association between subretinal fluid (SRF) and retinal blood flow in eyes with central serous chorioretinopathy (CSC) using a retinal functional imager (RFI) and optical coherence tomography angiography (OCTA). In this retrospective case–control study involving 26 eyes from 18 CSC patients and 25 eyes from 21 age- and sex-matched controls, we found that the CSC group showed significant differences from the control group in terms of the retinal venule blood flow velocity (3.60 ± 0.43 vs 3.96 ± 0.56 mm/s; p = 0.030), retinal venule blood flow rate (8.75 ± 2.67 vs 12.51 ± 7.12 nl/s; p = 0.040), and the diameter of retinal venules (118.26 ± 14.25 vs 126.92 ± 35.31 μm; p = 0.045). Linear regression analysis showed that SRF thickness accounted for a 36.9% reduction in venous BFR (p = 0.013). The difference in the O2 saturation between retinal arteries and veins was greater in the CSC group. There was no correlation between SRF thickness and capillary densities in OCTA. Our findings suggest that disturbance in venous return and the associated altered oxygen may be significant changes in the retinal blood flow dynamics in eyes with SRF.

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Retinal Vascular Reactivity in Central Serous Chorioretinopathy

Abstract: Unlike healthy subjects, retinal blood flow in patients with CSCR seems affected by rapid increases in BP and OPP. Our study suggests that the autoregulatory mechanisms controlling retinal microcirculation are not entirely able to counteract overperfusion in patients with CSCR.

Cited by 13 publications

References 34 publications

Patients with central serous chorioretinopathy not only have pachychoroidal disorders but also altered retinal metabolic function

Patients with central serous chorioretinopathy not only have pachychoroidal disorders but also altered retinal metabolic function

Retinal vascular reactivity in carriers of X-linked inherited retinal disease – a study using optical coherence tomography angiography

Subretinal fluid disturbs the retinal venous blood flow in central serous chorioretinopathy

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