The Influence Factors Of Subfoveal Choroidal Thickness In Chronic CSC And Its Relationship With TCM Syndromes

Objective:Measuring the subfoveal choroidal thickness in patients with chronic central serous chorioretinopathy(CSCR)by using coherent optical tomography depth enhanced imaging(EDI-OCT)to analyze the influencing factors of subfoveal choroidal thickness in chronic CSC patients and its relationship with TCM syndromes,exploring the TCM connotation relationship between them,in order to better guide clinical diagnosis and treatment.Methods:According to the inclusion and exclusion criteria,30 patients(60 eyes)with chronic CSC(group A)diagnosed by examination in the affiliated Hospital of Chengdu University of Traditional Chinese Medicine from October to October 2019,and 30 patients(60 eyes)with acute CSC(group B)were collected.According to the inclusion and exclusion criteria of the normal control group,30 healthy volunteers(group C,60 eyes)matched with the age and diopter of the study group were selected.And in accordance with the three syndromes of dampness and turbidity,stagnation and heat of the liver channel and deficiency of the liver and kidney,formulating the TCM symptom factor table,and at the same time differentiating the syndromes of patients in groups A and B.EDI-OCT technique was used to scan the horizontal and vertical orientation of the posterior polar macular fovea of the three groups.The linear distance between the Bruch and the inner surface of the sclera was taken as the subfoveal choroidal thickness.The SFCT was measured in the three groups to analyze the difference of SFCT between chronic CSC,acute CSC,and normal control group.And the relationship between SFCT of chronic CSC and acute CSC patients with age,course of disease,diopter and TCM syndromes.Results:1.There were 30 patients with chronic CSC(30 eyes with affected and 30 eyes with contralateral healthy eyes),including 19 males and 11 females,with an average age of 40.762±6.50.there were 30 patients with acute CSC(30 eyes with affected and 30 eyes with contralateral healthy eyes),including 21 males and 9 females,with an average age of 39.53±6.38 years old.There were 30 normal control cases(60 eyes),including 19 males and11 females,with an average age of 40.23±7.29 years old.statistical analysis showed that there was no significant difference in age and sex among the three groups.2.There was no significant difference in diopter,occupation and eye among chronic CSC group,acute CSC group and normal control group.3.The SFCT values of each group were expressed as mean ± standard deviation(x ±s).The SFCT values of affected eyes in group A and B were345.06±42.33μm and 456.93±73.18μm,those in contralateral healthy eyes in group A and B were 304.86±54.4μm and 327.10±77.85μm,respectively,and those in left and right eyes in group C were 263.26 ± 25.10μm and264.10±24.74μm,respectively.4.There were significant differences in SFCT between the affected eyes of the chronic CSC group and the contralateral healthy eyes,and between the SFCT of the affected eyes of the acute CSC group and the contralateral healthy eyes(P < 0.05).5.There was no significant difference in SFCT between the left eye and the right eye in the normal control group(P > 0.05).6.There was significant difference in SFCT between chronic CSC group and acute CSC group(P < 0.05).7.There was no significant difference in SFCT between the healthy side of chronic CSC and the healthy side of acute CSC(P > 0.05).8.There were significant differences in SFCT between chronic CSC group,acute CSC group and normal control group(P < 0.05).9.There were statistically significant differences in SFCT between the healthy side eyes of the chronic CSC group,the healthy side eyes of the acute CSC group and the normal control group(P < 0.05).10.There was no significant difference in the correlation between SFCTand the course of disease,age and diopter in chronic CSC group and acute CSC group(P>0.05).11.Among the 30 chronic CSC patients,there were 13 cases of stagnation-heat syndrome of the liver meridian(43.3%),11 cases of dampness-turbidity syndrome(36.7%),and 6 cases of liver-kidney deficiency syndrome(20.0%).Among the 30 acute CSC patients,17 cases were stagnation-heat syndrome of the liver channel(56.7%),7 cases were dampness-turbidity syndrome(23.3%),and 6 cases were deficiency of the liver and kidney(20.0%).TCM syndrome types of patients with chronic CSC and acute CSC: the number of cases of stagnation-heat syndrome of liver meridian is the most,followed by the syndrome of dampness and turbidity,and the number of cases of deficiency of liver and kidney is the least.12.There was no significant difference in the SFCT between the three types of TCM syndromes in patients with chronic CSC and acute CSC(P>0.05).Conclusion:1.The SFCT of chronic and acute CSC eyes was significantly thicker than that of contralateral healthy eyes and matched healthy control eyes.2.The SFCT of contralateral healthy eyes with chronic and acute CSC was significantly thicker than that of normal eyes,suggesting that CSC may be an ophthalmic disease with unilateral eye as clinical manifestation and bilateral eye disorder,which is related to the increase of SFCT.3.The SFCT of the eyes with chronic CSC was thinner than that of the eyes with acute CSC,but there was no significant difference in the SFCT of the contralateral healthy eyes,suggesting that there may be a decrease in choroidal blood flow in the macular regionor choroidal capillary atrophy in the eyes with chronic CSC.4.There is no significant difference in SFCT between healthy eyes,suggesting that the SFCT of healthy eyes is symmetrical.5.In this study,the TCM syndrome differentiation of acute and chronic CSC patients were mostly stagnant heat syndrome of liver meridian,and no significant correlation was found between TCM syndrome type and SFCT.