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Nobuhiro Terao, Tetsuya Yamagishi, Yuto Katoh, Shigeru Kinoshita, Chie Sotozono; Clinical characteristics of bilateral central serous chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4954.
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© ARVO (1962-2015); The Authors (2016-present)
To elucidate the clinical characteristics of patients with bilateral central serous chorioretinopathy (CSC).
This retrospective observational case series involved 128 eyes of 102 patients (19 eyes of 16 females and 109 eyes of 86 males; mean age: 54.3 years) with CSC diagnosed by optical coherence tomography (OCT), fluorescein angiography (FA), and indocyanine green angiography. Patients were divided into two groups as follows: patients with bilateral CSC (b-CSC Group) and those with unilateral CSC (u-CSC Group). Clinical diagnosis of b-CSC was based on the presence of serous retinal detachment (SRD) in at least 1 eye and past or present SRD in the fellow eye. The b-CSC group and u-CSC group were compared in regard to age, sex ratio, spherical equivalent (SE), axial length (AL), baseline best-corrected visual acuity (BCVA), last-visit BCVA, rate of chronic phase, subfoveal choroidal thickness (SCT), and rate of atrophic tract (AT). CSC of chronic phase was defined as cases with symptoms lasting more than 6 months and FA findings of widespread leakage from broad areas of retinal pigment epithelium damage. SCT was measured on enhanced depth imaging-OCT (EDI-OCT) images, and the presence of AT was confirmed based on fundus autofluorescence (FAF) images.
Fifty-two eyes of 26 patients (6 eyes of 3 females) were categorized into b-CSC Group and 76 eyes of 76 patients (13 eyes of 13 females) into u-CSC Group. With statistical significance, the b-CSC Group vs. the u-CSC Group, respectively, tended to show older age (mean age: 59.0 vs. 52.7 years; P=0.014), higher SE (0.01 diopters (D) vs. -1.15D; P<0.001), shorter AL (23.31mm vs. 23.82mm; P=0.017), higher rate of chronic phase (86.5% vs. 67.1%; P=0.013), higher rate of AT on FAF (26.9% vs. 2.6% ; P<0.001), and worse last-visit BCVA (logMAR: 0.19 vs. 0.05; P=0.019). No differences existed between the two groups in regard to sex ratio, BCVA at baseline, and SCT on EDI-OCT.
The findings of this study show that patients with b-CSC tend to be older and have shorter AL, higher SE, poor visual prognosis, higher rate of chronic phase, and higher rate of AT on FAF images in comparison with patients with u-CSC. Shorter AL with higher SE may be associated with the pathogenesis of b-CSC. Physicians should regard b-CSC as a severe form of the disease, and earlier therapeutic intervention is strongly recommended.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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