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Danial Mohabati, Tom O A R Missotten, Eiko de Jong, Camiel Boon, Suzanne Yzer; Risk of recurrent and chronic disease in a large cohort of acute central serous chorioretinopathy with long-term follow-up. Invest. Ophthalmol. Vis. Sci. 2018;59(9):6075.
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© ARVO (1962-2015); The Authors (2016-present)
To study typical acute cases of central serous chorioretinopathy (aCSC), and evaluate the risk of transition to a recurrent and chronic CSC phenotype, based on multimodal imaging.
The medical records and multimodal imaging at presentation were reviewed in patients diagnosed with CSC. Only typical aCSC patients were included showing serous subretinal fluid (SRF), one focal leakage spot on fluorescein angiography (FA), and retinal pigment epithelium (RPE) alterations limited to less than one optic disc diameter in size in the affected eye. All patients had to show complete recovery from the first CSC episode. Recurrence of CSC and disease progression were retrospectively investigated through multimodal imaging during follow-up. Increase in RPE alterations in the affected and unaffected eyes were accepted as signs of chronicity.
295 affected eyes of 291patients (75% male, mean age 43 years) were included. Mean Snellen visual acuity at diagnosis was 20/25. 153 eyes (52%) had a spontaneous resolution, while 142 eyes (48%) recovered after early treatment (mean: 1, range: 1-3 treatments) of their first episode. In 83 eyes one or more recurrence of SRF was reported (mean follow-up: 26 months). In a subgroup including 197 affected eyes (67%) with more than one year of follow-up (mean: 37, range: 12-247 months), 73 eyes (37%) experienced on average 1.4 CSC recurrences (range: 1-6 recurrences). On follow-up FA (30 months after baseline FA), 22 eyes (11%) showed an increase in cumulative RPE alterations over time, and RPE alterations were observed in 28 fellow eyes (14%) in this subgroup. Mean Snellen visual acuity in this subgroup, as well as the whole aCSC group was equal to 20/20 at final visit.
Based on clinical findings on multimodal imaging, most typical aCSC patients showed a spontaneous recovery of their first disease episode. In our study, one-third of aCSC patients showed a recurrent disease character, while only a small minority with documented long-term follow-up showed a more chronic process. The mean final visual outcome was good in the whole aCSC group.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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