Abstract
Purpose: :
To perform qualitative and quantitative analysis of subretinal protein deposits, seen in acute central serous retinopathy (CSR) patients, using high resolution spectral domain optical coherence tomography (SD-OCT), in order to investigate whether protein deposits present have any significant impact on best corrected visual acuity (BCVA). The secondary goal was to evaluate whether the presence of pigment epithelium detachment (PED) at baseline has any impact on final BCVA.
Methods: :
Patients diagnosed with acute CSR were included. Using SD-OCT, the following distances/heights were measured: central total retinal thickness, central neurosensory retinal thickness, the vertical and horizontal length of subfoveal subretinal fluid and subfoveal thickness of protein deposit (PD) layer, if present and could be measured. Secondary measures included measurement of the height and width of PED if present subfoveally.
Results: :
Thirty eight patients with acute CSR were included. Four types of PD, based on their shape and appearance (hanging, integrated, scattered, and massive), were noted. At least one type of PDs was seen at baseline SD-OCT exam in 84.2% (32/38) eyes. In 60.5 % (23/38) eyes more than one type of PD were present. PD subfoveal thickness could be measured in 20 (52.6%) out of 38 eyes. A significant correlation was found between the subfoveal thickness of PD layer and baseline/final visual acuities in the eyes: (r = 0.60, p = <0.001 and r = 0.45, p = 0.008, respectively). Those eyes with protein deposits which demonstrated a resolution of CSR (resolved subgroup, n = 11) at 3 (± 1) months of follow-up, had a significantly thinner (p = 0.003) subfoveal thickness of PD layer at baseline exam (28.8 ± 12.5 µm), than the unresolved group of eyes (n = 21)(57.0 ± 27.2 µm). The mean BCVA (LogMAR) at the baseline did not differ significantly between resolved and unresolved subgroups (0.43 ± 0.29 and 0.40 ± 0.22, respectively, p=0.375), however, at final follow-up, a significant difference (p=0.012) in BCVA was found between the resolved and unresolved subgroups (0.18 ± 0.20 and 0.33 ± 0.18, respectively), The final BCVA in eyes with and without PED at baseline was not significantly different (p=0.19).
Conclusions: :
The thickness of subfoveal protein deposits at baseline appears to be an important parameter related to the BCVA and time of CSR resolution, whereas the presence of PED at baseline didn’t have an impact on the final BCVA.
Keywords: imaging/image analysis: clinical • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • retinal detachment