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TIMSIT AURELIE, Elodie Bousquet, Irmela Mantel, martine elalouf, Ramin Tadayoni, Francine F Behar-Cohen; Phenotype of Central serous chorioretinopathy in female. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1546. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Central serous chorioretinopathy (CSCR) affects male in 80% of cases. The aim of this study is to investigate if the phenotype of this disease in female differs from male comparing risk factors, multimodal imaging and evolution.
Multicentric retrospective study analyzing all female presenting with a confirmed diagnosis of CSCR in Ophtalmopôle of Paris and Jules Gonin Eye hospital in Lausanne without any other concomitant eye disease. A control group of men diagnosed with CSCR was included consecutively from November 2017. The two groups were compared in terms of age, risk factors, subtype and evolution of the disease, clinical examination, multimodal imaging (SD-OCT, blue autofluorescence, fluorescein and ICG angiography) and presence of choroidal neovessel on OCT-angiography.
Datas of 53 women and 50 men were reviewed. Female were significantly older than male with a mean age of 53 years old versus 47 years old (p-value = 0,001). Almost 57% of female were menauposed. Among non-menauposed women 50% showed a recent use of corticosteroids. The use of corticosteroids was significantly more frequent in females with 60% versus 29% in male (p-value < 0,001). At the opposite, shift work was more frequent in male in 33,3% versus 11,4% (p-value = 0,002). In female, 65,4% of CSCR were chronic or persistent as compared 51,2% in male, who were more frequently acute (P-value = 0,051). CSCR seems to be more unilateral in female (90,5% vs 76,6%). The sub-retinal detachment in female was predominantly subfoveal with less involvement of the mild periphery or peripapillary area in 79% in female versus 58% in male (p-value = 0,019). The subfoveal choroid was thickened in both groups without any statistical difference; respectively 427 μm in female and 452,3 μm in male. Choroidal neovascularization (CNV) assessed by multimodal imaging was present in 26% of eyes in female versus 14% in male. In chronic CSCR in women, gravitational tracks are rarely observed.
In female, CSCR occurs at older age, is more frequently unilateral, chronic and subfoveal. Our results also suggest that in female, two distinct phenotypes are identified: - A typical acute form mostly associated to corticoid intake, - A chronic unilateral subfoveal SRD with a higher rate of CNV in post-menopause female. The frontier between the later form and pachychoroid neovasculopathy can be challenging in bthe absence of previous history of CSCR.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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