ICGA And FFA In Central Serous Chorioretinopathy And An Experimental Model Induced By Adrenaline In Rabbits

Background: Central serous chorioretinopathy (CSC) is a common disorder characterized by accumulation of serous fluid under the neurosensory retina secondary to a localized leak at the level of the retinal pigment epithelium (RPE) . Oppositely, idiopathic serous pigment epithelium detachment (IPED) is unusually seen, characterized by accumulation of serous fluid under localized retinal pigment epithelium. The pathogenesis of the focal changes in RPE, which cause detachment of the neurosensory retina is controversial. Disorder of choroidal circulation has been suggested as primary changes. Additionally, certain predisposing factors have been reported to induce or aggravate CSC, including type A personality, disturbing psychological events, endogenous hypercortisolism and hypercatecholamine , increased sympathetic activity, et al. Thus, it has been suggested that stress might be involved in etiology of CSC. Purpose: This study was performed to evaluate changes in choroidal circulation in cases of CSC and IPED, furtherly, to investigate the relationship between CSC and sympathetico-adrenomedullary system affected under stress, by using an experimental model induced by injection of adrenaline in epichoroidal spaces in rabbits. Methods: Part 1: Indocyanine green angiography ( ICGA) and fundus fluorescein angiography (FFA) in central serous chorioretinopathy -5- In 60 consecutive CSC patients, FFA and ICGA were performed with confocal scaning laser ophthalmoscope Heidelberg Retina Angiographyer(HRA). Part 2: ICGA and FFA in IPED In 5 consecutive patients with IPED, FFA and ICGA with HRA were performed. Part 3: Experimental model induced by adrenaline in rabbits Three ii L 0.1% adrenaline solution was administered to the epichoroidal space. For control rabbits, 3 iJ. L saline was injected .The fundus of injected eye of each rabbit was examinated by FFA, ICGA and optical coherence tomography (OCT) at 1 h and 1st 2nd 3rd 6th and 10th day after injection. A random selected rabbit was sacrificed and the eyes were excavated for light microscopy (LM) study. RESULTS: 1. Cases of CSC Localized choroidal filling delay was found in 113 eyes (94.2%), choroidal venous and capillary dilatation in 107 eyes (89.2%) in early phrase of ICGA, choroidal hyperfluorescence due to leaked fluorescence in 102 eyes (85%) in mid-phrase of JCGA. In 62 eyes (51.7%), choroidal leakage continued into late phrase of ICGA. In 48 eyes, hypofluorescence located at choriocapillary layer was observed. The mean time of arm-retina circulation time was 10.1 s in FFA. Depigment spots in 94 eyes(78.3%) and RPE leakage in 62 eyes(5 1.7%) were noticed in FFA, all these RPE lesions corresponded to areas of the abnormal choroid. No abnormal retinal circulation was seen in FFA. 2. Cases of IPED Localized choroidal filling delay, choroidal venous and capillary dilatation were found in 10 eyes (100%). In the late phrase of ICGA, localized choroidal hyperfluorescence corresponded to the site of PED was seen in 6 eyes (75%), where showed localized hypofluorescence in 4 eyes (25%). Late pooling of FFA was found in all focuses of PED. 3. Experimental model induced...