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Oscar C Kuruvilla, Neeti Alapati, Hilliary Inger, Zuhair Peracha, Daniel Kim, Paul A Edwards; Recurrence of central serous chorioretinopathy in patients who undergo intraocular surgery with subsequent topical steroid therapy.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6373. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate characteristics of patients who were diagnosed and treated for central serous chorioretinopathy (CSR) and subsequently undergo intraocular surgery.
This is a retrospective chart review of 103 patients who were diagnosed and treated for central serous chorioretinopathy at Henry Ford Hospital. All patients selected for review were treated between January 2005 and January 2013, although, they may have been initially diagnosed with CSR prior to this time period. Data collected included age, gender, refraction, history of open angle glaucoma, treatment administered, recurrences, intraocular surgeries, steroid drop usage, systemic steroid usage and fluorescein angiography findings.
We evaluated 106 eyes from 98 patients whose mean age was 52.7 years. The majority were male (67%) vs. female (33%). Fifty percent of patients were hyperopic, while 38% were myopic and 12% were emmetropic. Only 12% of affected eyes were pseudophakic. The majority of patients had acute disease (77%) while 19% had chronic disease and 4% had atypical disease. On fluorescein angiography, almost all patients (94%) had expansile dot patterns, 2% had smokestack and 2% had inverted smokestack patterns. Overall, 18% of patients experienced a recurrence of CSR. Patients who underwent intraocular surgery had no recurrences post operatively. Almost a third of patients developed recurrences during treatment with nasal steroids. Patients treated with laser, photodynamic therapy or acetazolamide had an overall recurrence rate of 7%.
CSR is a relatively common cause of visual loss. Our affected patients were more likely to be male, phakic hyperopes with acute disease and expansile dot seen on fluorescein angiography. In our review, recurrence rate was approximately 18%. None of the patients who had intraocular surgery experienced a recurrence of CSR despite routine use of topical steroids following surgery. In addition, among 14 patients who had initial treatment, only one had recurrence. The results from this retrospective review suggest that it is safe for patients with history of CSR to undergo intraocular surgery without worry for recurrence of disease.
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