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Alexandre Matet, Alejandra Daruich, Marta Zola, Francine F Behar-Cohen; Risk factors for recurrences in central serous chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2965.
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© ARVO (1962-2015); The Authors (2016-present)
To describe recurrence patterns and investigate candidate risk factors for recurrences after acute central serous chorioretinopathy (CSCR).
For this observational case series, systemic and multimodal imaging parameters influencing recurrences in 52 patients with acute CSCR were evaluated using a frailty Cox proportional hazard survival model. The evaluated covariates included systemic findings: age, gender, treatment, duration of previous episode, history of corticosteroid use, stress, shift work, sleep disorder, depression, allergy, and cardiovascular risk (hypertension/dyslipidemia); optical coherence tomography (OCT) findings: subfoveal choroidal thickness (SFCT), irregular pigment epithelial detachment (PED), number of subretinal hyperreflective foci at leakage site; angiographic findings: intense leakage on fluorescein angiography, multifocal choroidal hyperpermeability on indocyanine-green angiography.
Twenty-five of 52 subjects (48%) presented ≥1 recurrences during a mean follow-up of 29±10 months [range, 12-54 months]. Follow-up duration did not differ between cases with or without recurrences (P=.4). Worse visual acuity levels (logarithm of the minimal angle of resolution) were associated with higher number of episodes during follow-up (P=.009, r=.36). In a univariate analysis, higher SFCT (P=.019), irregular PED (P=.047), multiple subretinal hyperreflective foci on OCT (P=.011), and shift work (P=<.0001) were significantly associated with recurrences, with a near-significant influence of non-intense fluorescein leakage (P=.054) and allergy (P=.073). In a multivariate analysis, higher SFCT (P=.017), non-intense fluorescein leakage (P=.016) and shift work (P=.0003) remained significant and independent risk factors for recurrences.
These results contribute to identify CSCR patients at higher risk of recurrence, who could benefit from earlier and/or more intensive therapeutic intervention.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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