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Savastano, Maria, C., MD, PhD*; Dansingani, Kunal, K., MA, FRCOphth†,‡; Rispoli, Marco, MD*,§; Virgili, Gianni, MD; Savastano, Alfonso, MD; Freund, K., Bailey, MD**,††,‡‡; Lumbroso, Bruno, MD*

doi: 10.1097/IAE.0000000000001678
Original Study

Purpose: To compare the prevailing patterns of Haller vessel arrangements at the posterior pole between healthy eyes and those with central serous chorioretinopathy (CSC) using en face optical coherence tomography.

Methods: Eyes of normal subjects and patients with acute or chronic CSC underwent optical coherence tomography imaging (RTVue 100; Optovue Inc, Fremont, CA). En face sections at the level of the Haller layer were classified by two masked graders into five mutually exclusive morphologic categories (temporal herringbone, branched from below, laterally diagonal, double arcuate, and reticular). The relative prevalence of each Haller vessel arrangement pattern was determined for each phenotype.

Results: Numbers of eyes examined were as follows: 154 eyes of 77 normal subjects; 41 eyes of 31 patients with acute CSC; and 39 eyes of 33 patients with chronic CSC. The mean age of participants was 44.4 ± 14.6 years for healthy subjects (M:F = 37:40), 48.5 ± 8.2 years (M:F = 24:7) for acute CSC, and 65.3 ± 13.1 years (M:F = 28:5) for chronic CSC. The relative prevalence of each Haller vessel arrangement pattern differed by phenotype. The temporal herringbone pattern was most prevalent in healthy eyes (49.2%), whereas a reticular pattern was most prevalent in eyes with acute and/or chronic CSC (combined, 48.8%).

Conclusion: A significant difference was observed in the prevalence of respective Haller vessel arrangement patterns between eyes of normal subjects and those of patients with either acute or chronic CSC. Although further study is needed to determine the mechanistic factors underlying these differences, and the hemodynamic implications, our data suggest that en face optical coherence tomography may find a formal role in choroidal disease classification.

Examination of en face optical coherence tomography sections at the level of the Haller layer reveal vascular morphologic arrangements which have previously been classified into five patterns in normal subjects. This study shows that the relative prevalence of respective patterns differs in eyes of patients with central serous chorioretinopathy compared with those of normal subjects.

*Centro Italiano Macula, Rome, Italy;

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

Moorfields Eye Hospital, London, United Kingdom;

§Nuovo Regina Margherita Hospital, Rome, Italy;

Department of Translational Surgery and Medicine, Ophthalmology, University of Florence, Careggi, Florence, Italy;

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

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

‡‡Department of Ophthalmology, New York University School of Medicine, New York, New York.

Reprint requests: Maria C. Savastano, MD, PhD, Centro Italiano Macula, Via Angelo Brofferio, 7, 00195 Rome, Italy; e-mail:

B. Lumbroso and M. Rispoli are Consultant of Optovue. K. B. Freund is Consultant of Genetech, Heidelberg Engineering, Optos, Optovue, GrayBug Vision. None of the other authors has any financial/conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.