Choroidal Vessel Diameter Index Differences May Predict Subretinal Fluid in CSC

Choroidal vessel diameter index may predict subretinal fluid resolution and enable early intervention.

Choroidal vessel diameter index differences in the posterior pole between baseline and 3-month follow-up visits may be associated with subretinal fluid (SRF) in eyes with central serous chorioretinopathy (CSC), suggesting this vasculature feature may predict future SRF status, according to research published in Heliyon.

Researchers included patients (n=29; mean age, 58.3 years; 76% men) with treatment naïve CSC who presented to a university hospital between October 2021 and April 2022 in the observational case series. Study participants underwent enhanced depth imaging with widefield swept-source optical coherence tomography (SS-OCT) and choroidal thickness (CT), vessel density (VD), and choroidal vessel diameter index measurements in the superotemporal and inferotemporal subfields on the temporal side of an 18-mm circle from the disc.

Evaluating the vertical difference in the VDI in the choroid may be useful for predicting the spontaneous resolution of SRF.

The team stratified participants according to SRF status (present vs absent) at 3 months following a period of observation and evaluated changes in choroidal structures, calculated the vertical difference in CT and other choroidal angiographic parameters, and evaluated the association of these parameters with SRF status. 

At the 3-month follow-up visit, 10 (34.5%) eyes experienced SRC resolution compared with 19 (65.5%) eyes that experienced SRF persistence. The SRF status at 3 months was not associated with the vertical difference in CT (SRF-resolved: 41.5 μm vs SRF-persistent: 48.5 μm; P=.614) or with choroidal VD (SRF-resolved: 1.8% vs SRF-persistent: 3.2%; P=.065). It was, however, associated with the vertical difference in choroidal vessel diameter index (SRF-resolved: 0.66 vs SRF-persistent: 1.33; P=.017).

“Evaluating the vertical difference in the [vessel diameter index] in the choroid may be useful for predicting the spontaneous resolution of SRF,” according to the researchers. “Early interventions with [photodynamic therapy] may be necessary for eyes with significant vertical differences in [vessel diameter index] to prevent permanent impairment of visual function rather than simply monitoring the condition’s progression. By taking this approach, ophthalmologists may be able to prevent irreversible foveal damage and preserve better visual function in patients with CSC.”

Limitations of the study included the small sample size, short duration, and failure to account for duration of symptoms.

Disclosure: This research was supported by Alcon Japan, Ltd. and Canon Inc. Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Kogo T, Muraoka Y, Ishikura M, et al. Widefield choroidal vasculature associated with future condition of subretinal fluid in central serous chorioretinopathy. Heliyon. Published online July 20, 2023. doi:10.1016/j.heliyon.2023.e18441