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Choriocapillary blood propagation in normal volunteers and in patients with central serous chorioretinopathy
  1. Hideki Komatsu1,
  2. Josephine Young-Devall2,
  3. Gholam A Peyman3,4,5,
  4. Shin Yoneya1
  1. 1Department of Ophthalmology, Saitama Medical School, Moroyama, Saitama, Japan
  2. 2Wycombe Hospital, Wycombe, Buckinghamshire, UK
  3. 3Department of Ophthalmology, Tulane University, New Orleans, Louisiana, USA
  4. 4University of Arizona, Phoenix, Arizona, USA
  5. 5Arizona State University and Maricopa Hospital, Phoenix, Arizona, USA
  1. Correspondence to Dr Shin Yoneya, Department of Ophthalmology, Saitama, Medical School, 38 Morohongo, Moroyama, Iruma, Saitama 350-0451, Japan; shin{at}


Background/aims To evaluate early choroidal vascular dye-filling and dye propagation patterns in normal subjects and in patients with central serous chorioretinopathy (CSC) using indocyanine green (ICG) angiography.

Methods Seventeen healthy volunteers (21–81 years old) and six patients with CSC were included. ICG angiography was performed using a modified Topcon ICG video-camera system. Subtracted images were made using the early ICG frames at a time interval of 0.12 s. Ninety frames of time-sequential images for 3 s starting from the initial dye appearance in the choroid were prepared to construct an animated video.

Results The animated video demonstrated dye-filling and propagation patterns at the level of the choroid–choriocapillaris. In normal young volunteers, the initial phase of dye filling appeared as a uniform patchy fluorescence in the sub-foveal area, and then spread evenly in a centrifugal manner in all directions in a wave-like, pulsed fashion towards the equator. In normal older volunteers, the initial phase was similar to that in young volunteers, but centrifugal flow propagation of fluorescence towards the periphery showed an uneven progression and border. In patients with CSC, the initial dye showed a multiple patchy dye appearance with a significant time delay and loss of the centrifugal extension pattern.

Conclusion Using this new approach, various choroidal dye propagation patterns were observed in normal volunteers and in patients with CSC. A video of subtracted images allowed evaluation of the dynamics of dye propagation in the choroid–choriocapillaris.

  • Blood flow
  • central serous chorioretinopathy
  • choriocapillary
  • haemodynamics, indocyanine green angiography

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  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Saitama Medical School Institutional Review Board.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.