Bilateral central serous chorio-retinopathy in pregnancy presenting with severe visual loss

Chakraborti, Chandana; Samanta, Samiran; Faiduddin, Khandakar; Choudhury, Krittika Pal; Kumar, Simit; Mondal, Ramkrishna

doi:10.3126/nepjoph.v6i2.11711

Cited by 5 publications

(10 citation statements)

References 7 publications

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“…However, in a study of 173 patients by Rijssen, et al, there were no statistically significant differences in choroidal thickness between affected eyes and fellow eyes in untreated chronic CSCR [41]. This supports the bilateralism of CSCR in the literature [42,43]. Therefore, choroidal thickness is increased in both the affected and fellow eye.…”

Section: Choroidal Layer Thickness In Cscrmentioning

confidence: 78%

Current Choroidal Imaging Findings in Central Serous Chorioretinopathy

Nkrumah

Maltsev

Manuel

et al. 2020

Vision

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Background: Central serous chorioretinopathy (CSCR) is a chorioretinal disease affecting mostly middle age males. It is marked by the serous detachment of the neurosensory layer at the macula. This review of the literature provides a framework of the current characteristic/relevant imaging findings of CSCR. Although the pathogenesis of CSCR is unclear, the choroid plays a major role and its changes are fundamental to the diagnosis and treatment of CSCR. Methods: A systematic literature search focusing on current multimodal imaging for CSCR was performed. Only articles reporting on original clinical data were selected, studies in a language other than English were included only if an English abstract was provided. Additional sources included articles cited in the references list of the first selected articles. We deduced imaging findings based on current and relevant literature on the topic. Results: We found that sub foveal choroidal thickness (SFCT) and choroidal vascularity index (CVI) were greater in eyes with acute CSCR than in eyes with chronic CSCR or normal eyes. There was increased choroidal thickness (CT) in the macula compared to peripapillary region. In healthy eyes, the highest CVI was found in the nasal region followed by the inferior, temporal, and superior quadrant. The area with the least CVI was the macula. In eyes with CSCR, 100% had asymmetric dominant vortex veins compared to 38% in normal eyes. Conclusion: Choroidal imaging has advanced the diagnosis of CSCR. This has led to numerous imaging biomarkers like CVI, CT, and hyper-reflective dots for early detection and possible prognostication of CSCR. More techniques like wide field scans and en face imaging are being employed to characterize the choroid in CSCR.

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Section: Choroidal Layer Thickness In Cscrmentioning

confidence: 78%

Current Choroidal Imaging Findings in Central Serous Chorioretinopathy

Nkrumah

Maltsev

Manuel

et al. 2020

Vision

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“…Although half-dose PDT was shown to be effective in promoting resolution of subretinal fluid in this case, the EZ at the fovea remained discontinuous 30 months after half-dose PDT with little improvement in visual acuity. Therefore, although most eyes with pregnancy-associated CSC recover spontaneously around the time of delivery ( Table 1 ) [ 2 – 13 , 15 , 16 ], all patients, especially those who are older, might require regular follow-up to confirm complete resolution of subretinal fluid. Half-dose PDT can be administered early if the amount of subretinal fluid shows little reduction after delivery.…”

Section: Discussionmentioning

confidence: 99%

“…Acute central serous chorioretinopathy (CSC), a common macular disease, usually presents with a well-circumscribed serous retinal detachment at the posterior pole on clinical examination and one or more leakage points at the level of the retinal pigment epithelium (RPE) on fluorescein angiography (FA) [1]. Pregnancy-associated CSC typically develops in the third trimester and is characterized by the onset of subretinal hyperreflective fibrin, spontaneous, and complete resolution of subretinal fluid around the time of delivery and good final visual acuity [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]. Cases have been reported in Caucasian, black, Native American, Hispanic, and Middle Eastern women [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics of Pregnancy-Associated Central Serous Chorioretinopathy in the Chinese Population

Jiang

et al. 2021

Journal of Ophthalmology

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Purpose. To investigate the clinical characteristics of pregnancy-associated central serous chorioretinopathy (CSC) in the Chinese population. Methods. The medical records of patients diagnosed with pregnancy-associated CSC from February 2012 to October 2019 were retrospectively reviewed. Best-corrected visual acuity (BCVA), symptom duration, pregnancy-related medical information, and optical coherence tomography (OCT) images were collected. Results. Nine patients (11 eyes) were included. Five women were in their first pregnancy and four were in their second pregnancy, two of whom experienced CSC in their first pregnancy as well. The mean age was 35.00 ± 3.97 years. The mean symptom duration at the initial visit was 19.73 ± 13.65 days. The mean gestational age at the time of development of CSC was 27.11 ± 2.09 weeks. The mean BCVA (logarithm of the minimum angle of resolution (logMAR)) at the initial visit was 0.36 ± 0.18 (Snellen 20/45, range 20/100–20/25). All eyes showed subretinal hyperreflective fibrin on OCT images at the initial visit. Four patients (4 eyes) were lost to follow-up before fluid resolution. The mean BCVA at the final visit was logMAR 0.10 ± 0.15 (Snellen 20/25, range 20/50–20/20)). One eye in the oldest patient had persistent subretinal fluid at 26 months postpartum. The subretinal fluid resolved completely after half-dose photodynamic therapy (PDT); however, the ellipsoid zone at the fovea remained discontinuous at 30 months after half-dose PDT. The remaining six eyes all showed spontaneous resolution of subretinal fluid around delivery and regained intact ellipsoid zone. Conclusions. Pregnancy-associated CSC in Chinese developed mostly in the third trimester and usually recovered spontaneously around delivery with good final visual acuity. However, patients might require long-term follow-up until complete resolution of subretinal fluid and to detect recurrences. Half-dose PDT can be administered early if there is little reduction in the amount of subretinal fluid after delivery.

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“… 27 , 28 In some cases, there is resolution of CSCR, either partially or completely after delivery. 28 …”

Section: Pregnancymentioning

confidence: 99%

Biomarkers for central serous chorioretinopathy

et al. 2020

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Central serous chorioretinopathy (CSCR) is a common chorioretinal disease characterized by serous retinal detachment that most commonly involves the macular region. Although the natural history of the acute form shows a self-limiting course, a significant number of patients suffer from recurrent episodes leading to chronic disease, often leaving patients with residual visual impairment. Visual morbidity is often worsened by a delay in the diagnosis due to the incorrect understanding of the particular biomarkers of the disease. The aim of this review is to provide clinical understanding of the biomarkers of CSCR with an emphasis on the most recent findings in patient demographics, risk factors, clinical imaging findings, and management options. Patients with these biomarkers, age 30–44 years, male gender, increased stress levels, hypercortisolism (endogenous and exogenous exposures), sleep disturbance, pregnancy, and genetic predisposition have increased susceptibility to CSCR. Also, biomarkers on optical coherence tomography (OCT) such as choroidal thickness (CT) and choroidal vascularity index (CVI) showed good diagnostic and prognostic significance in the management of CSCR. There are nonspecific features of CSCR on OCT and OCT angiography such as choroidal neovascularization, photoreceptor alteration/cone density loss, and flat irregular pigment epithelium detachment. We described rare complications of CSCR such as cystoid macular edema (CME) and cystoid macular degeneration (CMD). Patients with CME recovered some vision when treated with anti-vascular endothelial growth factors (anti-VEGFs). Patients with CMD had irreversible macular damage even after treatment with anti-VEGFs.

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Bilateral central serous chorio-retinopathy in pregnancy presenting with severe visual loss

Cited by 5 publications

References 7 publications

Current Choroidal Imaging Findings in Central Serous Chorioretinopathy

Current Choroidal Imaging Findings in Central Serous Chorioretinopathy

Clinical Characteristics of Pregnancy-Associated Central Serous Chorioretinopathy in the Chinese Population

Biomarkers for central serous chorioretinopathy

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