Abstract
Purpose :
To describe recurrence patterns and investigate candidate risk factors for recurrences after acute central serous chorioretinopathy (CSCR).
Methods :
For this observational case series, systemic and multimodal imaging parameters influencing recurrences in 52 patients with acute CSCR were evaluated using a frailty Cox proportional hazard survival model. The evaluated covariates included systemic findings: age, gender, treatment, duration of previous episode, history of corticosteroid use, stress, shift work, sleep disorder, depression, allergy, and cardiovascular risk (hypertension/dyslipidemia); optical coherence tomography (OCT) findings: subfoveal choroidal thickness (SFCT), irregular pigment epithelial detachment (PED), number of subretinal hyperreflective foci at leakage site; angiographic findings: intense leakage on fluorescein angiography, multifocal choroidal hyperpermeability on indocyanine-green angiography.
Results :
Twenty-five of 52 subjects (48%) presented ≥1 recurrences during a mean follow-up of 29±10 months [range, 12-54 months]. Follow-up duration did not differ between cases with or without recurrences (P=.4). Worse visual acuity levels (logarithm of the minimal angle of resolution) were associated with higher number of episodes during follow-up (P=.009, r=.36). In a univariate analysis, higher SFCT (P=.019), irregular PED (P=.047), multiple subretinal hyperreflective foci on OCT (P=.011), and shift work (P=<.0001) were significantly associated with recurrences, with a near-significant influence of non-intense fluorescein leakage (P=.054) and allergy (P=.073). In a multivariate analysis, higher SFCT (P=.017), non-intense fluorescein leakage (P=.016) and shift work (P=.0003) remained significant and independent risk factors for recurrences.
Conclusions :
These results contribute to identify CSCR patients at higher risk of recurrence, who could benefit from earlier and/or more intensive therapeutic intervention.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.