Changes in choroidal blood flow velocity in patients diagnosed with central serous chorioretinopathy during follow-up for pachychoroid pigment epitheliopathy

PURPOSE: To evaluate chronological changes in choroidal blood flow velocity in two patients with pachychoroid pigment epitheliopathy (PPE) and central serous chorioretinopathy (CSC) in the same eye. OBSERVATIONS: Two males aged 36 and 43 years old with PPE were diagnosed with CSC in the same eyes during follow-up. Using laser speckle flowgraphy, the macular mean blur rate (MBR), an index of relative blood flow velocity, was sequentially evaluated in the affected and unaffected eyes. In the affected eye, the macular MBR values at the onset of PPE and CSC were higher, at 25% and 33% in Case 1 and 21% and 51% in Case 2, respectively, than those on PPE regression; but the same trends were not observed in their fellow eyes. The increases in MBR changing rates were 1.3 and 2.5 times higher in Cases 1 and 2, respectively, at the onset of CSC than those at the onset of PPE. CONCLUSION AND IMPORTANCE: In the affected eyes, the rates of MBR change increased at the alternate onsets of PPE and CSC. The increased MBR changing rates were 1.3–2.5 times higher at the onset of CSC than those at the onset of PPE. Our data suggest that choroidal hyperperfusion is involved in the pathogenesis of both diseases and that its severity may differ between CSC and PPE. These results may support the hypothesis that PPE and CSC clinically overlap and have a common pathogenic background.