Low incidence of pachydrusen in central serous chorioretinopathy in an Indian cohort

Purpose: The aim of this study is to report the prevalence, clinical and swept-source optical coherence tomography (SS-OCT) characteristics of pachydrusen in eyes with central serous chorioretinopathy (CSCR) and their fellow eyes. Methods: A total of 264 eyes of 132 patients with a diagnosis of CSCR (acute/persistent/recurrent/chronic/inactive) in atleast one eye, were analyzed in this retrospective, cross-sectional study. SS-OCT parameters including choroidal thickness (CT), large choroidal vessel layer thickness (LCVT) at fovea and the site of pachydrusen were recorded. Paired t test and analysis of variance (ANOVA) was used to compare CT in eyes with CSCR (subfoveal and site of pachydrusen) and multiple groups respectively. Results: The mean age of the study patients was 42.9 � 9.5 years with 119 males (90.15%). Bilateral CSCR was present in 31 patients. Nine eyes (chronic, 4; persistent, 2; and inactive/resolved CSCR, 3) showed presence of pachydrusen with an overall prevalence of 6.82% (9 eyes of 9 patients out of 132 patients). There was no significant difference of subfoveal CT (SFCT) in eyes with CSCR (422.4 � 107.8 ?) vs fellow eyes (407.0 � 96.5 ?) and eyes with CSCR associated with pachydrusen (413.7 � 101.5 ?) vs fellow eyes of CSCR eyes with pachydrusen (431.6 � 188.8 ?) (P = 0.71). LCVT as a percentage of CT was higher at the site of pachydrusen compared to SFCT (69.8% vs. 50.8%). Conclusion: CSCR can be associated with pachydrusen with a lower prevalence rate than previously reported. Whether the thickened large choroidal vessels at site of pachydrusen play any role in formation in pachydrusen needs further evaluation.

Validating the pachychoroid disease spectrum using multimodal imaging

Pachychoroid disease spectrum has garnered considerable interest and has been discussed in detail in recent literature. It refers to a group of retinal and choroidal disorders, namely pigment epitheliopathy, central serous chorioretinopathy, neovasculopathy, and polypoid choroidal vasculopathy, all arising from a thickened choroid and hyperpermeable large choroidal vessels. We describe a case which had simultaneous presentation of multiple disorders on the pachychoroid spectrum. Multimodal findings in this patient have been described in this report. The presence of pachychoroid should prompt thorough imaging since coexistence of multiple disorders can potentially change the management and follow-up schedule of these patients.