Risk Factors for Posterior Cystoid Retinal Degeneration in Central Serous Chorioretinopathy

Abstract

Disease duration longer than 5 years and subretinal fibrosis are associated with the development of PCRD in CSC. Prospective evaluations could substantiate the associations found in this study and further clarify their significance.

Central serous chorioretinopathy: Recent findings and new physiopathology hypothesis

“…They may disappear or fluctuate, suggesting fluid passage through a compromised RPE contribute to their formation. Interestingly, in the interpapilomacular region, intraretinal cysts are often observed earlier in the disease evolution, over areas of RPE atrophy (Iida et al, 2003;Piccolino et al, 2008aPiccolino et al, , 2008b. Hyper-reflective dots frequently accumulate in the subretinal space below the detached neurosensory retina (Kon et al, 2008;Maruko et al, 2011a;Spaide and Klancnik, 2005) and within several retinal layers (Ahlers et al, 2009;Kon et al, 2008;Yalcinbayir et al, 2014).…”

“…In addition to chronic SRD, OCT shows multifocal RPE atrophy in areas corresponding to the hypoautofluorescent tracks, and irregular RPE detachments. Intraretinal cystoid cavities can also be observed (Iida et al, 2003;Piccolino et al, 2008a) and are associated with disease duration longer than 5 years (Piccolino et al, 2008b). Aggressive forms of chronic CSCR characterized by bullous SRD and massive exudation with subretinal fibrin deposits have been referred to as "multifocal posterior pigment epitheliopathy" (Uyama et al, 1999), a term rarely employed in the recent literature.…”

Effect of Ocular Contusion in a Patient With Chronic Central Serous Chorioretinopathy

“…2,3 I hypothesized that a direct chorioretinal interstitial communication at that site, in a condition of choroidal exudation, may be responsible for PCRD in CSC. 2,3 This case of chronic CSC in which a dramatic increase of intraretinal exudation follows a contusive injury of the eye supports a critical role of chorioretinal adherences in the development of PCRD in CSC.…”

“…1 Considering the preferential extrafoveal distribution of the cystoid lesions and the preserved visual acuity in many cases, I recently used "posterior cystoid retinal degeneration" (PCRD) to define the pathologic pattern of retinal changes that develops in patients with chronic CSC. 2,3 In this disease, cystoid cavities of the retina are frequently found at the site of subretinal fibrosis, large laser scars, or spontaneous atrophic lesions of the retinal pigment epithelium (RPE) and the choroid, where chorioretinal adherence developed. 2,3 I hypothesized that a direct chorioretinal interstitial communication at that site, in a condition of choroidal exudation, may be responsible for PCRD in CSC.…”

Central serous chorioretinopathy: an update on pathogenesis and treatment

“…102 Duration of symptoms more than 5 years and subretinal fibrosis have been identified as risk factors for the development of posterior cystoid retinal degeneration in CSC, but this is not necessarily associated with marked reduction in visual acuity. 103 On the contrary, there are cases of foveal atrophy associated with severe visual loss in long-standing serous macular detachment without any cystoid changes in the retina. 101 One intriguing feature of CSC is the ability of photoreceptors to continue to function above a serous retinal detachement.…”