Research Information System
GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, 2026 (SCI-Expanded, Scopus)
Purpose To perform a multiscale assessment of retinal and choriocapillaris microvascular alterations in chronic central serous chorioretinopathy (CSC) using optical coherence tomography angiography (OCTA) metrics and fractal-based descriptors, and to introduce a novel index quantifying choriocapillaris flow-void organisation. Methods This prospective study included 40 eyes with chronic CSC, 40 fellow eyes, and 40 eyes from 40 age- and sex-matched healthy controls. Superficial and deep capillary plexus (SCP/DCP) angiograms were analysed for conventional vascular metrics, foveal avascular zone (FAZ) parameters, and multifractal descriptors. Choriocapillaris (CC) flow voids were quantified as total non-flow area, flow deficit percentage, void count, mean void area, and largest void area. The vascular coalescence index (VCI) was defined as the ratio of the largest void area to the total number of voids to reflect flow-void coalescence. Results SCP metrics were largely preserved, although FAZ perimeter was greater in CSC eyes than in control eyes. DCP showed significant impairment in CSC eyes, including reduced vessel density and length, and increased vessel diameter index and non-flow area, compared with controls (all p < 0.05). CC analysis revealed higher non-flow area and flow deficit percentage in CSC eyes (both p = 0.001), accompanied by fewer voids and larger mean void areas (p = 0.006, p = 0.001, respectively). VCI was significantly higher in CSC and fellow eyes than in control eyes (p = 0.002 and p = 0.007, respectively). Conclusions Chronic CSC demonstrates layer-specific microvascular disruption predominantly affecting the DCP and CC, with CC flow-void reorganisation beyond simple non-perfusion. VCI provides a quantitative descriptor of CC flow-void coalescence, complementing conventional OCTA metrics.