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Julia M. Fullerton, Douglas J. Covert, David V. Weinberg; Accuracy of Referring Diagnosis in Central Serous Chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2139.
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To explore relationships between presenting patient characteristics such as age, visual acuity, exam findings, and referring diagnosis in patients with active central serous chorioretinopathy (CSCR).
Retrospective chart review of patients with a diagnosis of CSCR. Inclusion criteria included examination by an Eye Institute retina specialist during active disease with supporting fundus exam and imaging from May 2005 through October 2008. Age, presenting visual acuity (VA), referring diagnosis, presenting medications, exam findings on OCT, and FA, as well as final VA were recorded. Logistic regression was used to determine if accuracy of referring diagnosis was associated with other baseline covariates.
59 cases of active CSCR (48 men and 11 women) met inclusion criteria. Mean age of presentation was 51.2 years (SD=13.3 years), median 51 years. Presenting VA ranged from 20/20 to 20/200 with a mean of 20/39.1 and median 20/40. 30 patients of the 57 (52.6 %) with recorded referring diagnosis were referred with a diagnosis of CSCR. Mean VA of patients with referring diagnosis of CSCR was 20/31, whereas mean VA with any other diagnosis was 20/49 (p=0.05). For every one year increase in age, referring diagnosis was 0.95 times as likely to be CSR (95% CI: 0.91-0.99, p=0.027). 15 of 59 (25.4%) patients were on corticosteroids (oral, topical, or inhaled) on presentation. Patients who were using any form of corticosteroid on presentation were 0.25 times as likely as patients without current corticosteroid use to be referred with a diagnosis of CSCR (95% CI: 0.069-0.92, p =0.036).
Slightly over half of patients with central serous chorioretinopathy were referred to a retina subspecialist with a correct diagnosis. Younger age, better visual acuity, and absent use of corticosteroids were associated with a greater likelihood of a correct referring diagnosis.
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