Central serous chorioretinopathy (CSCR) is characterized by neurosensory retinal detachment. Because the retina pigment epithelium and choroidal pathology is the current mechanism in CSCR, many studies in the literature focused on the outer retinal layers. There is little information about the functional or histological structure of the detached retina. In this study, we assess the ganglion cell complex (GCC) thickness using optical coherence tomography (OCT) in patients with acute and chronic CSCR. The medical records of 16 acute and 19 chronic CSCR patients which have no other disorders that cause a serous macula detachment were analyzed. Chronic cases were also divided into two subgroups: chronic active and chronic nonactive CSCR. The eyes with extramacular involvement or cystoid degeneration and cases which developed choroidal neovascularization were excluded from the study. The mean, minimum, superior-nasal, superior, superior-temporal, inferior-nasal, inferior, and inferior-temporal GCC values obtained using OCT were used for analysis. The duration from the onset was 7.8 ± 4.5 weeks and the mean age was 45.0 ± 10.7 years in acute CSCR, and in chronic cases the values were 36.0 ± 6.2 weeks and 52.9 ± 10.5 years, respectively. There were no significant differences in sex distribution. The chronic cases were statistically significantly older than acute cases (p = 0.02). While there was no difference between the acute and chronic cases, there were statistically significant differences between the chronic CSCR and control group in all values of GCC. Additionally, there were statistically significant differences between the acute CSCR and control group in mean, minimum, and superior-temporal GCC thicknesses. Although choroid and outer retinal layers play an important role in the pathogenesis of CSCR, there is scant information about the functional or histological structure of the detached retina in CSCR. Our results showed that GCC was significantly reduced in both acute and chronic CSCR compared to healthy subjects. Analysis of ganglion cell helps us understand the etiology of the patients which healed anatomically but had limited visual improvement in CSCR.
One-year systemic use of isotretinoin had no significant effect on the thickness of macula ganglion cell. Macular ganglion cell analysis is useful for determining and following the toxic effects of systemic drugs on the retina. However, it is more rational to consider it as an adjunct to electrophysiological testing rather than used alone.
A 23-year-old girl presented to the clinic with metamorphopsia and photopsia in her left eye. After detailed ophthalmic examination, central retinal vein occlusion with optic disc edema was detected in that eye. Three days after diagnosis, the patient returned to our clinic with visual acuity decrease. Central retinal artery occlusion sparing cilioretinal artery was detected. All the laboratory tests were normal except for heterozygous methylenetetrahydrofolate reductase mutation (A1298C genotypes) and an indefinite Lyme disease seropositivity. Symptoms and visual disturbance recovered without any further treatment other than acetylsalicylic acid for prophylaxis.
GCC thickness increased significantly until month 6 compared with baseline values in most of the macular segments post-PRP in the PDR group. The GCC thickness at month 12 was not different from the baseline thickness in any of the macular segments.
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