Macular Neovascularization Associated with Central Serous Chorioretinopathy: Multimodal Imaging-Based Predictors

Abstract

Purpose : To investigate predictors for macular neovascularization (MNV) associated with central serous chorioretinopathy (CSCR) based on multimodal imaging

Methods : Retrospective multi-center chart review study of 134 eyes of 128 consecutive patients with CSCR. Eyes were classified per the multimodal imaging-based classification of CSCR at baseline into i) simple/ complex CSCR & ii) primary episode/ recurrent/ resolved CSCR. Baseline characteristics of MNV and predictors were evaluated with ANOVA.

Results : Of the 134 eyes with CSCR, MNV was present in 32.8% (n=44). Based on severity, those with MNV primarily consisted of complex (72.7%, n=32), followed by simple (22.7%, n=10), and atypical (4.5%, n=2) types. Those without MNV, in contrast, were more commonly simple (55.6%, n=50) than complex (44.4%, n=40). Compared with complex CSCR with MNV cohort, simple CSCR with MNV had a better baseline decimal visual acuity (0.72 vs 0.49, p=0.03) without differences in age (mean 59 vs 59 years, p=0.76), subfoveal choroidal thickness (SFCT 393 vs 390 μm, p=0.997), and reported duration of symptoms (median 6 vs 18 weeks, p=0.38).

Based on presentation, those with MNV were as likely to be primary (45.5%, n=20) as recurrent (45.5%, n=20), with the rest as resolved cases (9.1%, n=4). No differences between primary, recurrent vs resolved cohorts were found in age (mean 58, 61 vs 52, p=0.27), visual acuity (mean 0.56, 0.50 vs 0.65, p=0.66), SFCT (414, 383 vs 329 μm, p=0.55), and duration (median 7, 7 vs 30, p=0.42). However, primary CSCR with MNV were older (58 vs 47, p=0.00003), worse visual acuity (0.56 vs 0.75, p=0.01), and of longer duration (median 7 vs 1, p=0.0002) than those without MNV. Similarly, recurrent CSCR with MNV were older (61 vs 52, p=0.004), without differences in visual acuity (0.50 vs 0.61, p=0.31), SFCT (383 vs 424 μm, p=0.21), and duration (median 7 vs 2, p=0.32) than those without MNV. Further analysis of MNV characteristics in each subgroup and predictive modeling is underway.

Conclusions : Prevalence of MNV associated with CSCR was 32.8% and more likely in complex CSCR and older age. Complex CSCR with MNV also had worse baseline visual acuity than simple CSCR with MNV and complex CSCR without MNV. Primary and recurrent presentations were similarly accounted for nearly half of MNV cases. Multimodal imaging-based classification of CSCR supports detailed analysis of associated MNV.

This is a 2021 ARVO Annual Meeting abstract.