Spontaneous resolution of subretinal fluid in chronic central serous chorioretinopathy: the Fuji sign

Abstract

Purpose : Patients with chronic central serous chorioretinopathy (cCSC) may have spontaneous subretinal fluid (SRF) resolution, but little is known about clinical characteristics that can help to predict which patients will have such a spontaneous resolution. We performed a retrospective clinical study to learn about factors that may predict spontaneous SRF resolution in cCSC patients.

Methods : This retrospective cohort study included 38 treatment-naive cCSC patients in whom spontaneous SRF resolution on optical coherence tomography (OCT) occurred, and 38 gender- and age-matched cCSC patients from the multicenter randomized controlled trials PLACE and SPECTRA, who received treatment after baseline visit. In both groups, clinical characteristics and findings on multimodal imaging were assessed at first presentation. Most importantly, the OCT scan was analyzed for the presence of the Fuji sign, a novel morphological feature on OCT in which SRF has a triangular shape resembling the Japanese Mount Fuji. In addition, the number of focal leakage points on fluorescein angiography (FA) and presence of SRF on OCT in the fellow eye were assessed.

Results : The Fuji sign on OCT occurred significantly more often in the study group compared to the control group (16/38 (42.1%) vs 5/38 (13.2%), respectively; p=0.005). The number of focal leakage points on FA was 0.83 ± 0.72 in the study group and 1.71 ± 1.64 in the control group (p<0.001). SRF on OCT was also present in the fellow eye at baseline visit in 5/38 (13.2%) patients in the study group and in 9/38 (23.7%) patients in the control group.

Conclusions : The Fuji sign on OCT and number of focal leakage points on FA can help to identify which cCSC patients with foveal SRF have a higher chance of spontaneous SRF resolution without treatment.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.