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Joao C. Ribeiro, Luiz Roisman, Vagnaldo Fechine, Nilva Moraes, Mauro Campos; The Relationship Between Macular Sensitivity And Retinal Thickness In Eyes With Central Serous Retinopathy: Is Initial Loss Of Macular Sensitivity An Early Predictor Of Chronicity?. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5226.
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We investigated relationship between macular sensivity and retinal thickness in Central Serous Retinopathy (CSC) and then we analyze if initial lost of macular sensitivity is an early predictor of chronicity of CSC
It was designed to be prospective observational study. Patients were referred to Retina Service after screening exams performed at ER Eye Clinic from Federal University of Sao Paulo within Jun to Nov/2011. 14 eyes from 14 patients were included after diagnosed CSC that caused visual acuity disturbance and OCT-retinal detachment and were followed at least for a period of 3 months. Volunteers with vitreous opacity were excluded, as well as lens opacity, or any eye surgery within 6 months before measurements. After consent, patients underwent eye examination and were submitted to SD-OCT and fundus microperimetry with MAIA. After 3 months of follow up without any treatment, visual acuity (VA) measurement, quantification of retinal thickness SD-OCT and microperimetry analysis were performed again. Main outcome measures were logMAR VA, quantification of average sensivity for central macula, fixation pattern, and relationship between macular sensitivity and retinal thickness. It was also calculated ROC (Receiver Operating Characteristic) curve to set the best cutoff point of macular sensivity that would be able to predict whether patient with acute CSC would progress to be chronic, based on OCT serous retinal detachment. According to cutoff point, it was calculated sensivity, specificity, positive and negative predictive values (PPV, NPV) for macular sensivity as method to predict if acute CSC will progress to chronicity
Moderate significant correlation was found between macular sensivity and thickness in acute CSC (r= -0.57,P=0.03). Weak correlation, but not statistically significant, was found between macular sensivity and thickness in chronic CSC (r= -0.35,P=not significant). Based on ROC curve, it was obtained cutoff point of less than 20 dB of macular sensivity as the best balance between sensivity and specificity to predict chronicity. With this cutoff point, method had sensivity of 71% and specificity of 100% with PPV of 100% and NPV of 78%. Furthermore, we verified that eyes with microperimetry less than 20 dB and acute CSC had relative risk of 4.5 to progress to be chronic
We observed a moderate significant inverse correlation among macular sensivity and thickness in the acute CSC. Also, we verified that microperimetry with cutoff point of 20 dB is good exam to predict if the acute serous retinal detachment will progress to chronicity
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