Correlation between redefined optical coherence tomography parameters and best-corrected visual acuity in non-resolving central serous chorioretinopathy treated with half-dose photodynamic therapy

Abstract

PurposeTo assess parameters on optical coherence tomography (OCT), and their correlation with best-corrected visual acuity (BCVA) in patients with non-resolving central serous chorioretinopathy (CSC).MethodsFor 25 non-resolving CSC patients treated with photodynamic therapy (PDT), the thickness of retinal layers was assessed on the foveal spectral-domain (SD) OCT scan. Evaluated OCT parameters included the central retinal thickness (CRT), defined as the internal limiting membrane (ILM) to ellipsoid zone (EZ) distance, and the second band thickness (SBT), defined as the EZ to hyperreflective subretinal accumulation distance. Integrity of the external limiting membrane (ELM) and the EZ bands was also determined. These parameters, along with BCVA and CRT measured automatically by SD-OCT device software were obtained before PDT, after PDT, and at final visit. After Bonferroni correction, a p-value <0.007 was considered statistically significant.ResultsTwenty-five patients could be included at last visit before PDT and first visit after PDT. At final visit, 24 patients could be included, since 1 patients was lost to follow-up. Mean CRT was 112 μm at last visit before PDT, 118 μm at first visit after PDT (p = 0.030), and 127 μm at final visit (p<0.001compared to baseline). Mean SBT was 74 μm, 26 μm (p<0.001 compared to baseline), and 21 μm (p<0.001 compared to baseline), respectively. Mean BCVA in Early Treatment of Diabetic Retinopathy Study letters was 79 at baseline, 85 at first visit after PDT (p = 0.005 compared to baseline), and 87 at final visit (p = 0.001 compared to baseline). BCVA had an estimated correlation of β = 0.103 (p = 0.114) with CRT, β = -0.051 (p = 0.014) with SBT, β = 0.615 (p = 0.600) with the integrity of the ELM, and β = 4.917 with the integrity of the EZ (p = 0.001).ConclusionsIn non-resolving CSC patients treated with half-dose PDT, the CRT increased at final visit in comparison to the last visit before PDT. The continuity of the EZ on SD-OCT was positively correlated with BCVA. We propose that the distance between ILM and EZ should be used as a reliable CRT measurement in non-resolving CSC patients treated with half-dose PDT.

Transfoveal Micropulse Laser Treatment of Central Serous Chorioretinopathy within Six Months of Disease Onset

“…The traditional definition of chronic CSCR refers only to disease duration and does not account for the nature of RPE decompensation (i.e., focal, diffuse, or indistinct) or disease damage to the retina and/or RPE at presentation. These are the main clinical factors that influence the anatomic and functional responses to treatment [34,35,36,37]. Thus, the traditional acute versus chronic dichotomy applied to CSCR fails to accurately capture disease complexity in important ways.…”

Predictive factors of metamorphopsia after reduced-fluence photodynamic therapy in patients with central serous chorioretinopathy with good baseline visual acuity

“…The increase in ONL thickness was defined as the amount of ONL thickness increased at 12 months after RFPDT compared to that at baseline. The area of SRD was calculated by plotting the SRD lesion on the IR images based on a previous report [7]. We also evaluated the presence of pigment epithelial detachment (PED), the disruption of the ELM layer, and the disruption of the ellipsoid zone (EZ) layer within 500 μm from the fovea.…”

Patient characteristics of untreated chronic central serous chorioretinopathy patients with focal versus diffuse leakage

“…The outcome of FAF imaging was categorized as either predominantly hyperautofluorescent, predominantly hypoautofluorescent, or a combination of hypo-and hyperautofluorescence, based on the degree of autofluorescence that was most common within the vascular arcades. Central foveal thickness (CFT) was defined as the distance between the inner borders of the internal limiting membrane and the inner border of the ellipsoid zone on SD-OCT [18]. Subfoveal choroidal thickness (SFCT) was defined as the distance between the outer border of the RPE layer and the inner border of the choroid-sclera junction on enhanced depth imaging SD-OCT.…”