CENTRAL SEROUS CHORIORETINOPATHY: High-Resolution Imaging of Asymptomatic Fellow Eyes Using Adaptive Optics Scanning Laser Ophthalmoscopy.

PURPOSE: To investigate cone density in the asymptomatic fellow eye of patients with unilateral central serous chorioretinopathy (CSCR). METHODS: Seventeen asymptomatic fellow eyes of patients with unilateral CSCR and 17 eyes of aged-matched and gender-matched healthy controls underwent adaptive optics ophthalmoscopy. Cone density and spacing were assessed at the fovea. Clinical and multimodal imaging findings were also recorded. RESULTS: In the CSCR group, the patient mean age was 48.9 ± 9.8 years. The mean (±SD) subfoveal choroidal thickness was 417.8 ± 125.2 µm. The foveal external limiting membrane and ellipsoid zone were intact in all patients. Adaptive optics fundus imaging showed a significant decrease in cone density at 2° of eccentricity nasal and temporal to the fovea in asymptomatic fellow eyes of patients with unilateral CSCR compared with controls (P = 0.001 and P = 0.027, respectively). No statistically significant difference in cone density was found at 4° of eccentricity nasal and temporal to the fovea between both groups. CONCLUSION: Asymptomatic fellow eyes of patients with unilateral CSCR showed a reduced density of foveal cones in the absence of a decreased visual acuity and photoreceptor line disruption on optical coherence tomography. These results suggest that the photoreceptors could be damaged independently of the occurrence of a serous retinal detachment.

Choroidal imaging in patients with Cushing syndrome.

AIMS: Glucocorticoid intake is a well-established risk factor for central serous chorioretinopathy that belongs to the pachychoroid spectrum disease (PSD). The study aimed to assess the prevalence of PSD and analyse the choroidal phenotype in patients with Cushing syndrome. METHODS: A cross-sectional study was performed in Ophtalmopôle hôpital Cochin, Paris, France, with a systematic evaluation of hospitalized patients with Cushing syndrome, between November 2017 and July 2018. 56 eyes from 28 Cushing syndrome patients and 56 eyes of 28 age and gender-matched, and close spherical equivalent healthy participants were included. All patients underwent a complete ophthalmic examination including Enhanced-Depth Imaging (EDI)-Optical Coherence Tomography (OCT). Measures of subfoveal, 1000 µm nasal and 1000 µm temporal choroidal thicknesses were realized, and the presence of choroidal pachyvessels was evaluated. Hormonal tests evaluated the corticotropic axis. RESULTS: The number of eyes with PSD was significantly higher in Cushing syndrome patients as compared to controls (21.4% versus 3.6%, p = 0.004). In Cushing patients' eyes, 17.9% had a pachychoroid pigment epitheliopathy (PPE) and 3.6% had a polypoidal choroidal vasculopathy. Pachyvessels were more common in Cushing syndrome patients than in healthy subjects (71.4% versus 42.9%, p = 0.002). Mean subfoveal choroidal thickness was 331 ± 110 µm in Cushing patients, with no statistical difference between the two groups. There was no correlation between choroidal thickness and urinary and salivary cortisol levels. CONCLUSION: Patients with Cushing syndrome have a higher prevalence of PDS. An ophthalmologic specialized follow-up of these patients with EDI-OCT could detect chorioretinal abnormalities and adapt the surveillance of these patients.