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CHOROIDAL CHANGES ASSOCIATED WITH SEROUS MACULAR DETACHMENT IN EYES WITH STAPHYLOMA, DOME-SHAPED MACULA OR TILTED DISK SYNDROME

Tan, Anna C. S. MD, FRCSED*,†,‡; Yzer, Suzanne MD, PhD§; Freund, K. Bailey MD*,†; Dansingani, Kunal K. MA, FRCOphth*,†,¶,**; Phasukkijwatana, Nopasak MD, PhD††,‡‡; Sarraf, David MD‡‡,§§

doi: 10.1097/IAE.0000000000001402
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Purpose: To study the relationship of choroidal abnormalities with serous retinal detachment (SRD) in eyes with staphyloma, dome-shaped macula, or tilted disk syndrome.

Methods: Group 1, 28 eyes of 20 patients with staphyloma/dome-shaped macula/tilted disk syndrome associated with SRD was compared with Group 2, 30 eyes of 20 patients, with staphyloma/dome-shaped macula/tilted disk syndrome but without SRD. Radial and en-face optical coherence tomography and choroidal analysis were performed.

Results: Group 1 had a thicker mean subfoveal choroidal thickness (161 μm vs. 92 μm, P < 0.05) and a greater variation in choroidal thickness (112 μm vs. 76 μm, P > 0.05) compared with eyes of Group 2. Focal abrupt changes in choroidal thickness were more commonly seen in Group 1 versus eyes in Group 2 (90% vs. 30%, P < 0.05) and this area of abrupt change was located within or at the edge of the SRD in 64% of eyes. Large choroidal vessels (pachyvessels) (82% located within the area of SRD) were always associated with the presence of SRD.

Conclusion: An abrupt transition in choroidal thickness may be involved in the pathogenesis of SRD. In some cases, a radial scan pattern may better demonstrate mild SRD, choroidal contours and the focal choroidal variations than horizontal or vertical raster scan patterns.

Alterations in the choroid are seen in eyes with staphyloma or dome-shaped macula with serous macular detachments.

*Vitreous Retina Macula Consultants of New York, New York, New York;

LuEsther T Mertz Retinal Research Center, Manhattan, Eye, Ear and Throat Hospital, New York, New York;

Singapore National Eye Center, Singapore Eye Research Institute, Singapore, Singapore;

§The Rotterdam Eye Hospital, Rotterdam, the Netherlands;

Truhlsen Eye Institute, University of Nebraska, Omaha, Nebraska;

**Moorfields Eye Hospital, London, United Kingdom;

††Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand;

‡‡Stein Eye Institute, University of California, Los Angeles, California; and

§§Greater Los Angeles VA Healthcare Center, Los Angeles, California.

Reprint requests: David Sarraf, MD, Stein Eye Institute, UCLA, 100 Stein Plaza UCLA, Los Angeles, CA 90095-7000; e-mail: dsarraf@ucla.edu

Supported by The Macula Foundation, Inc, New York, New York.

K. B. Freund is Consultant to Genentech, Optos, Optovue, REGENXBIO, Heidelberg Engineering, Bayer HealthCare and DigiSight. D. Sarraf is a consultant of Bayer, Genentech, and Optovue and receives research grants from Allergan, Genentech, Heidelberg, Regeneron, and Optovue. The remaining authors have no conflicting interests to disclose.

A. C. S. Tan developed the study design, conducted the analysis, and prepared the manuscript and figures; Suzanne Yzer and Nopasak Phasukkijwatana recruited patients and prepared the images for analysis; K. K. Dansingani was involved in the study design and edited the manuscript and figures; S. Yzer, K. B. Freund, and D. Sarraf were the senior authors who provided the cases, developed the study design, edited and reviewed the manuscript, and provided the scientific expert advice on the manuscript.

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© 2017 by Ophthalmic Communications Society, Inc.