June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Subretinal choroidal neovascularization in central serous chorioretinopathy resistant to mineralocorticoid receptor antagonists
Author Affiliations & Notes
  • Alexis Kassotis
    Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, United States
  • Vlad Diaconita
    Ophthalmology, Edward S Harkness Eye Institute, New York, New York, United States
  • Tongalp H Tezel
    Ophthalmology, Edward S Harkness Eye Institute, New York, New York, United States
  • Footnotes
    Commercial Relationships   Alexis Kassotis, None; Vlad Diaconita, None; Tongalp Tezel, None
  • Footnotes
    Support  N/A
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 637. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Alexis Kassotis, Vlad Diaconita, Tongalp H Tezel; Subretinal choroidal neovascularization in central serous chorioretinopathy resistant to mineralocorticoid receptor antagonists. Invest. Ophthalmol. Vis. Sci. 2021;62(8):637.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
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.

 

Figure 1. Percentage of patients with CNV and cumulative resolution percentile during treatment with eplerenone. Subretinal fluid resolves in 50% of cases before 5 months. While only 20% of these eyes develop CNV, this rate doubles to 40% for eyes that require treatment for greater than 5 months.

Figure 1. Percentage of patients with CNV and cumulative resolution percentile during treatment with eplerenone. Subretinal fluid resolves in 50% of cases before 5 months. While only 20% of these eyes develop CNV, this rate doubles to 40% for eyes that require treatment for greater than 5 months.

 

Figure 2. Binomial regression analysis with relative risk ratios identifying which clinical factors increase risk of CNV development.

Figure 2. Binomial regression analysis with relative risk ratios identifying which clinical factors increase risk of CNV development.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×