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Danial Mohabati, Elon H.C. van Dijk, Myrte Breukink, Carel C B Hoyng, Marina Marinkovic, G Dijkman, Camiel J F Boon; Influence of corticosteroid use on clinical characteristics and therapeutic outcome in chronic central serous chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3719.
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© ARVO (1962-2015); The Authors (2016-present)
Corticosteroid exposure has previously been suggested as a risk factor for the development of chronic central serous chorioretinopathy (cCSC). In this study we assess whether the clinical characteristics and therapeutic outcome are different in cCSC patients who use (or have used) corticosteroids.
We retrospectively reviewed the medical records of 54 patients (59 eyes) who had been diagnosed with cCSC and had received their first treatment (44 photodynamic therapy, 9 focal Argon laser treatment, 6 micropulse laser therapy) between 2005 and 2014. Thirty eyes had a history of corticosteroid exposure (cases), and 29 eyes were without any exposure (controls). Cases with other retinal or choroidal comorbidities or the ones with an earlier treatment in the study eye were excluded. The main outcome measures included best-corrected visual acuity (BCVA), reduction of central retinal thickness (CRT), and resolution of subretinal fluid (SRF) on optical coherence tomography (OCT). Statistical analyses were performed using one-way independent ANOVA test and Mann Whitney test.
The mean BCVA before therapy was 69 ETDRS letters in the case group and 72 ETDRS letters in the control group (p=0.449). The mean BCVA at six weeks post-therapy was 75 ETDRS letters in cases and 74 ETDRS letters in controls (p=0.815). The mean BCVA at final follow-up (mean=26.5 weeks) was 70 ETDRS letters in the steroid-associated cCSC group versus 72 ETDRS letters in the control group (p=0.841). In 22 cases (73%) there was a complete resolution of SRF while in control group there were 19 eyes (66%) with a complete resolution (p=0.514). However, this resolution happened significantly faster in the control group compared to the steroid-associated group: an average of 8.4 weeks (±3.7 SD) versus an average of 13.1 weeks (±11.4 SD)(p=0.001), respectively. The mean CRT reduction on OCT was 111 µm (20.2 SE) in cases versus 141 µm (22.3 SE) in controls at first follow-up (p=0.371), and 114 µm (23.3 SE) in cases versus 224 µm (46.1 SE) in controls at last follow-up (p=0.824).
In this exploratory study, corticosteroid exposure does not seem to have a significant impact on functional and anatomical results of treatment in cCSC. However, resolution of SRF may be significantly faster in cCSC patient without a history of corticosteroid exposure.
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