Long-term Visual Outcomes and Causes of Vision Loss in Chronic Central Serous Chorioretinopathy

Mrejen, Sarah; Balaratnasingam, Chandrakumar; Kaden, Talia R; Bottini, Alexander; Dansingani, Kunal K.; Bhavsar, Kavita V.; Yannuzzi, Nicolas A.; Patel, Samir N.; Chen, Kevin C.; Yu, Shizhu; Stoffels, Guillaume; Spaide, Richard F.; Freund, K. Bailey; Yannuzzi, Lawrence A.

doi:10.1016/j.ophtha.2018.12.048

Cited by 184 publications

(181 citation statements)

References 41 publications

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“…However, there was no difference in CFT ( p = 0.244) or SFCT ( p = 0.063). Mrejen et al [2] reported a 41.5% disruption of the EZ at the first visit of 217 eyes, which conformed to our ratio of 20/48 (41.67%). As for CFT and SFCT, the study of Hamzah et al [17] had shown that chronic CSC had lower CFT and higher SFCT.…”

Section: Discussionsupporting

confidence: 90%

“…However, chronic CSC can be a sight-threatening disease, as 12.8% of patients are legally blind with best-corrected visual acuity (BCVA) of 20/200 or worse in the 10-year follow-up. Patients with a chronic course of CSC suffer a persistent SRD, accompanied by diffuse retinal pigment epithelium atrophy, cystic macular degeneration, even choroidal neovascularization [2].…”

Section: Introductionmentioning

confidence: 99%

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Quantitative Assessment of Retinal Capillary Vessel Density and Foveal Avascular Zone Area in Central Serous Chorioretinopathy Using OCTA

et al. 2020

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To quantitatively assess the retinal capillary vessel density (VD) and foveal avascular zone (FAZ) area in acute and chronic central serous chorioretinopathy (CSC) patients compared to healthy subjects using optical coherence tomography angiography (OCTA) and determine their correlation with visual acuity (VA). Methods: This was a cross-sectional, case-control study. All subjects were divided into three groups: acute CSC, chronic CSC, and healthy controls. The best-corrected VA test, optical coherence tomography, and OCTA were performed on the same day. In this study, we recorded and compared the main data of FAZ and VD in 3 × 3 mm OCTA images among three groups, also calculated the correlation between OCTA variables and VA in CSC patients. Results: A total of 148 subjects (148 eyes) were included in this study, with 50 eyes in acute CSC, 48 eyes in chronic CSC, and 50 eyes in control groups. The mean age was 50.11 ± 8.14 years. Chronic CSC had the significantly lowest VD both on the superficial and deep retina and the largest FAZ (0.39 ± 0.13 mm 2) compared to acute CSC and controls (all p < 0.05). There was no statistical difference between acute CSC and controls on VD or FAZ (both p > 0.05). In chronic CSC, both the decreased VD on deep retina and expanded FAZ were correlated with a worse VA (both p < 0.05). Conclusions: OCTA could serve as a reliable tool to evaluate different courses of CSC quantitively. In 3 × 3 mm OCTA images, both decreased VD and expanded FAZ were observed in chronic CSC patients.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Quantitative Assessment of Retinal Capillary Vessel Density and Foveal Avascular Zone Area in Central Serous Chorioretinopathy Using OCTA

et al. 2020

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“…33 Their presence were found to be correlated not only to disease duration, but also to poorer nal visual acuity. 17,35 Interestingly, despite the fact that both ellipsoid zone and ELM deterioration classically is related to longer disease duration, no signi cant difference was found in disease duration or reoccurence between the good and poor responder groups. One explanation for these results could be that in recurrent and chronic CSCR the duration of neurosensory detachment is often doubtful.…”

Section: 15mentioning

confidence: 89%

“…16 Matsumoto et al showed that the ON layer thickness positively correlates with the visual acuity in resolved CSCR and the discontinuity in the ellipsoid zone is associated with worse visual acuity. 17 A recent study reviewed clinical and multimodal imaging data of 133 patients with CSCR and found that outer retinal disruption on OCT is signi cantly associated with poorer visual acuity. 18 Sacconi et al reported possible biomarkers on ICG-angiography and OCT-angiography which could predict the response to eplerenone treatment in CSCR patients.…”

Section: 15mentioning

confidence: 99%

Predictive factors of selective mineralocorticoid receptor antagonist treatment in chronic central serous chorioretinopathy

Gergely

Kovács

Récsán

et al. 2020

Preprint

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Purpose: To compare the macular morphology of good and poor responders to eplerenone treatment in chronic central serous chorioretinopathy (CSCR) patients. Methods: 30 eyes of 29 patients with chronic CSCR were treated with 50 mg/day oral eplerenone and followed up for one year. The integrity of outer retinal layers at baseline was assessed using optical coherence tomography. Patients who showed complete resolution of subretinal fluid at one year were assigned to the good responder group (Group 1), whilst those who showed moderate or no resolution were classified as poor responders (Group 2). Results: Ellipsoid zone interruption, ELM interruption and hyperreflective foci in outer segment (OS) and outer nuclear layer (ONL) was significantly more frequent in Group 2 than in Group 1 (p<0.05 for all parameteres). Outer segment elongation was significantly more frequently seen in Group 1 than in Group 2 (p<0.05) Multivariable regression analysis showed that intact ellipsoid zone at baseline is an independent predictor of good therapeutic response, with an odds ratio of 26.00 (95% CI: 3.69–183.45; p=0.001) after controlling for the effect of hyperreflective foci and ELM integrity.Conclusion: There is higher chance of the resolution of subretinal fluid after eplerenone treatment in CSCR patients with intact outer retinal layers at baseline. Baseline morphologic evaluation of the outer retinal layers on OCT scans can be useful in predicting the response to mineralocorticoid receptor antagonist therapy in these patients.

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“…Central serous chorioretinopathy (CSCR) is a common retinal disorder that if persistent, recurrent, or chronic, can lead to permanent vision loss [ 1 ]. Although there have been considerable advances in recent years in our understanding of the anatomic characteristics and imaging features of the condition, the etiology and pathophysiology of the disorder remains incompletely understood.…”

mentioning

confidence: 99%

Lack of efficacy of eplerenone for treatment of active central serous chorioretinopathy

Sadda

2020

Eye

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Long-term Visual Outcomes and Causes of Vision Loss in Chronic Central Serous Chorioretinopathy

Cited by 184 publications

References 41 publications

Quantitative Assessment of Retinal Capillary Vessel Density and Foveal Avascular Zone Area in Central Serous Chorioretinopathy Using OCTA

Quantitative Assessment of Retinal Capillary Vessel Density and Foveal Avascular Zone Area in Central Serous Chorioretinopathy Using OCTA

Predictive factors of selective mineralocorticoid receptor antagonist treatment in chronic central serous chorioretinopathy

Lack of efficacy of eplerenone for treatment of active central serous chorioretinopathy

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