Disturbances of the choroidal microcirculation in patients with central serous chorioretinopathy

Background Advanced methods for indocyanine green (ICG) video-fluorescence angiography provide improved evaluation of choroidal blood flow disturbances in patients with central serous chorioretinopathy (CSC). Material and method Fluorescein ICG video-fluorescence angiography using a laser scanning ophthalmoscope and digital image processing were performed in patients with acute or chronic recurrent CSC. Results In all eyes examined delayed arterial filling followed by capillary and/or venous congestion were found in the areas of retinal pigmentepithelial detachment or leakage. Furthermore, additional ischemic choroidal capillary lobuli could be observed throughout the fundus of diseased eyes and ''normal'' fellow eyes. Conclusions Our results suggest that symptomatic changes in CSC, like RPEdetachment or leakage from the outer blood-retinal barrier, may be caused by capillary and venous congestion, possibly due to stress-related arterial hypoperfusion.