Korean J Ophthalmol.  2019 Dec;33(6):493-499. 10.3341/kjo.2019.0063.

Effect of Acetazolamide on Choroidal Morphology in Central Serous Chorioretinopathy

• Kwak JH
• Hong SW
• Ra H
• Kim EC
• Kang NY
• Baek J

• KMID: 2465128
• DOI: http://doi.org/10.3341/kjo.2019.0063

Abstract

PURPOSE
We sought to elucidate the influence of acetazolamide on choroidal structure changes during the treatment of central serous chorioretinopathy (CSC).
METHODS
This was a retrospective study of 45 eyes from 45 patients with acute CSC who were divided into an acetazolamide group (group 1, n = 20) and an observation group (group 2, n = 25). The main outcome measures were the changes in best-corrected visual acuity, subretinal fluid (SRF) height, subfoveal choroidal thickness (SFCT), and choroidal vascularity index (CVI) at one week, one month, two months, and three months, respectively.
RESULTS
Although statistical significance was not reached, best-corrected visual acuity improved in both groups at month 3 (from 0.06 ± 0.07 to 0.01 ± 0.03 in group 1 and 0.17 ± 0.24 to 0.09 ± 0.18 in group 2; p = 0.083 and 0.183, respectively). Separately, SRF height and CVI showed a significant decrease at three months in both groups (all p < 0.05), while a significant SRF height decrease was also noted in group 1 at one month (p = 0.038). In group 1, a significant decrease in the SFCT and CVI started at one week and one month (p = 0.021 and 0.008), respectively. However, in group 2, a significant decrease in the SFCT and CVI started at one month and two months (p = 0.005 and 0.015), respectively.
CONCLUSIONS
Acetazolamide has no effect on final functional or anatomical status at three months in eyes with CSC but does shorten the time for SRF absorption and accompanying choroidal structural changes.

Keyword

Acetazolamide; Central serous chorioretinopathy; Choroidal thickness; Choroidal vascularity index

MeSH Terms

Absorption
Acetazolamide*
Central Serous Chorioretinopathy*
Choroid*
Humans
Outcome Assessment (Health Care)
Retrospective Studies
Subretinal Fluid
Visual Acuity
Acetazolamide

Figure

• 

  Fig. 1 Enhanced depth imaging optical coherence tomography and processing for converting binary to obtain the choroidal vascularity index. (A) Subfoveal choroidal area within a width of 1,500 µm was selected using the polygon selection tool and the total choroidal area was marked. (B) To get a clear cut of the choroid-scleral junction, the Niblack autolocal threshold tool was used. (C) Then, the selected region was added to the region of interest manager. (D) By using the color threshold, luminal area (LA, arrow) was described and subsequently added to the region of interest manager. LA appeared as an area of dark pixels and stromal area as an area of light pixels. Total choroidal area, LA, and stromal area were calculated. Choroidal vascularity index was calculated by dividing the LA by the total circumscribed subfoveal choroidal area.

• 

  Fig. 2 Changes in (A) best-corrected visual acuity (BCVA), (B) subretinal fluid (SRF) height, (C) subfoveal choroidal thickness (SFCT), and (D) choroidal vascularity index (CVI) during the 3-month follow-up period. *p < 0.05, calculated by comparing initial data and follow-up data; †p < 0.05, calculated by comparing the difference between the two groups at each follow-up visit.

• 

  Fig. 3 Comparison of changes in subretinal fluid (SRF) height, subfoveal choroidal thicknes (SFCT), and choroidal vascularity index (CVI) during the three-month follow-up period in (A) group 1 and (B) group 2. *p < 0.05, calculated by comparing baseline and follow-up data.

• 

  Fig. 4 Comparison of choroidal thickness changes including the main central serous chorioretinopathy (CSC) lesion and the subfoveal choroidal thickness during the 3-month follow-up period in each group. *p < 0.05, calculated by comparing baseline and follow-up data.

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