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Alejandra B Daruich, Alexandre Matet, Laetitia Marchionno, Ali Dirani, Irmela Mantel, Aude Ambresin, Francine F Behar-Cohen; Central serous chorioretinopathy: profile of subretinal fluid spontaneous resolution. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3728.
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Central serous chorioretinopathy (CSC) is a disorder characterized by the occurrence of a serous retinal detachment usually confined to the macula, with leakage of fluid through the RPE into the subretinal space. Many treatments have been proposed, but the optimal timing for intervention remains unclear.<br /> The aim of this study is to analyze the kinetics of spontaneous resolution of subretinal fluid (SRF) in order to determine the optimal timeframe for treatment.
15 patients with acute unilateral treatment-naive idiopathic CSC were retrospectively included. Patients with a baseline examination within 30 days after onset of symptoms and a monthly follow-up for at least 4 months were included. Data for clinical, angiographic and spectral-domain optical coherence tomography (SD-OCT) examinations were recorded. The height of foveal SRF was noted, and SRF volume was estimated. The subfoveal choroidal thickness was also recorded.
80% of patients (n = 12) had spontaneous resolution of foveal SRF before the 4th month of follow-up, while 20% of patients (n = 3) had persistent foveal SRF. The mean resolution time was 92 ± 40 days. The analysis of SRF volume variations showed two profiles. In the first one (53% of patients), there was an initial increase of SRF volume until the 60th day, followed by a gradual decrease. In the second profile (47% of patients), the SRF volume decreased gradually from the beginning of the follow-up. Each profile was associated with specific pattern on fluorescein angiography (P= 0.005). Subfoveal choroidal thickness was similar in both profiles (P=0.86). The kinetics of SRF volume was not always correlated with the kinetics of the height of foveal SRF. The volume profiles were not predictive of the final outcome. Among the 3 patients with persistent SRF after 4 months, both profiles were observed, followed by a further SRF increase after the 120th day.
Two initial profiles of SRF kinetics were observed in acute CSC patients that were not predictive of the full duration of the detachment. Before the 4th month, the kinetics and the volume of SRF cannot help treatment decision. <br />
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