Abstract
Purpose :
Choroidal neovascular membranes (CNV) are an infrequently explored complication of central serous chorioretinopathy (CSCR) that can substantially impact recovery. This retrospective case analysis aims to better characterize the role of CNV in patients with CSCR who failed treatment with the mineralocorticoid receptor antagonist eplerenone.
Methods :
Those included in this study were diagnosed with CSCR without CNV at presentation in one physician’s practice between January 2012 and August 2019. All subjects had imaging with Spectral Domain Optical Coherence Tomography (SD-OCT) and angiography. Chart review was used to extract subjects' age, gender, risk factors, treatment, vision at the time of diagnosis and resolution, and date of resolution if applicable. Central macular thickness (CMT), subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI) were determined from SD-OCT images. Binary logistic regression analyses were conducted to identify clinical features associated with CNV development.
Results :
This study includes 35 eyes of 31 patients. Twenty-four eyes (68.6%) demonstrated complete resolution of subretinal fluid within 8.5 ± 1.9 months. Eleven eyes (31.4%) developed CNV. CNV incidence doubled after 5 months at which time 50% of the patients had complete resolution of subretinal fluid with eplerenone (Figure 1). Of eyes that did not resolve with eplerenone, a significantly higher proportion had CNV than did not (66.7% vs 20%, p=0.02). Binomial regression analyses indicate that the persistence of subretinal fluid (RR 5.99; CI: 1.21-29.41; p=0.028) and duration of eplerenone use (RR 1.06; CI: 1.00-1.13; p=0.042) were the only clinical features significantly associated with the presence of CNV in CSCR (Figure 2).
Conclusions :
Individuals without CNV at presentation who fail to respond to eplerenone treatment within 5 months may have developed an underlying CNV and thus, could benefit from investigatory imaging.
This is a 2021 ARVO Annual Meeting abstract.