Funduscopy-guided fluorescein angiography-free focal laser photocoagulation for central serous chorioretinopathy

Abstract

Purpose: To identify and correlate hypopigmented spots on fundoscopy with the leakage points on fluorescein angiography (FA) in patients with central serous chorioretinopathy (CSCR) to provide criteria for FA-free focal laser photocoagulation (FLP). Methods: Fifty consecutive patients of acute CSCR were evaluated between March and October 2019 confirming the inclusion and exclusion criteria. Colocalization of leakage points with discrete hypopigmented spots on clinical fundoscopy was evaluated using FA. Positive predictive value (PPV) was calculated to identify the status of association between these to formulate criteria for FA-free FLP of CSCR patients in future. Results: Out of the 50 eyes, 38 (76%) had a discrete hypopigmented spot on fundoscopy which coincided with the leakage point on FA. The PPV of finding a leakage point at the area of discrete hypopigmented spot is 95%. Colocalization with a pigment epithelial detachment was found in 25 (65.7%) of these 38 eyes. Retinal pigment epithelial irregularities were found associated in all of these 38 eyes. Subretinal homogenously hyperreflective material was found in 8 (21.05%) of 38 eyes. optical coherence tomography following FLP of leakage point in all cases showed complete resolution of CSCR in 47 (94%) eyes. Conclusion: This study demonstrates that hypopigmented spots on clinical fundus examination in CSCR patients, when present, coincide with the leakage point of FA. This may aid to undergo FA-free FLP treatment in CSCR patients.

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“…A total of 83% of participants overall knew something about mucormycosis, and 86% understood that this was an emergency. Among the participants, more than 50% were unaware that diabetes raises the risk of mucormycosis [ 12 ]. One study from Bangladesh found that the majority of pupils (63.8%) spent close to two hours researching COVID-19 and Black Fungus (Mucormycosis) on electronic and social media.…”

Central serous chorioretinopathy

“…Fluorescein angiography (FAG) allows to observe leakage of fluid into the subretinal space through the defects in RPE [58]. In CSC, usually, two types of patterns can be seen.…”