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  6. Reduction In Choroidal Thickness Associated With The Progression Of Pachychoroid Spectrum Diseases

Reduction in choroidal thickness associated with the progression of pachychoroid spectrum diseases

Hidetaka Matsumoto1, Junki Hoshino2, Kosuke Nakamura2

  • 1Department of Ophthalmology, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan. hide-m@gunma-u.ac.jp.

Japanese Journal of Ophthalmology|June 14, 2025

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Summary

Choroidal thickness decreases as pachychoroid spectrum diseases progress from central serous chorioretinopathy (CSC) to pachychoroid neovasculopathy (PNV) and polypoidal choroidal vasculopathy (PCV). This thinning is more pronounced with aging in affected eyes compared to normal controls.

Area of Science:

  • Ophthalmology
  • Retinal Diseases
  • Choroidal Imaging

Background:

  • Pachychoroid spectrum diseases, including central serous chorioretinopathy (CSC), pachychoroid neovasculopathy (PNV), and polypoidal choroidal vasculopathy (PCV), are characterized by distinct choroidal changes.
  • Understanding the progression and comparative choroidal morphology is crucial for diagnosis and management.

Purpose of the Study:

  • To compare choroidal thicknesses in macular and peripheral areas among eyes with CSC, PNV, and PCV.
  • To evaluate these thicknesses against normal control eyes.

Main Methods:

  • A retrospective case-control study involving 117 eyes with treatment-naïve pachychoroid spectrum diseases (52 CSC, 27 PNV, 38 PCV) and 106 matched controls.
  • Quantitative analysis of widefield choroidal thickness maps generated by widefield optical coherence tomography.
  • Determination and comparison of mean choroidal thickness in macular and four peripheral areas.

Main Results:

  • Mean choroidal thickness decreased progressively from CSC to PNV and PCV across all measured areas, with significant differences between CSC and the other two conditions.
  • The reduction in choroidal thickness with aging was greater in pachychoroid spectrum diseases than in normal controls.
  • No significant difference in mean choroidal thickness was found between PNV and PCV.

Conclusions:

  • Choroidal thickness generally decreases with the progression of pachychoroid spectrum diseases.
  • This decline may be linked to reduced choroidal blood flow and choriocapillaris attenuation, influenced by aging and the underlying pachychoroid pathophysiology.
Keywords:
Choroidal congestionChoroidal thicknessChoroidal venous overloadPachychoroid

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