Abstract
Purpose :
Pigment epithelial detachment (PED) is a common finding in eyes with central serous chorioretinopathy (CSCR). There is a lack of literature on follow-up changes in PEDs in CSCR and prognostic factors. We conduct a long-term analysis of structural changes and clinical outcomes in CSCR eyes with PED.
Methods :
Retrospective chart review and OCT imaging analysis study from a single tertiary care hospital. Inclusion criteria included eyes with both CSCR and PED and clinical and OCT imaging data for three consecutive years. Exclusion criteria included eyes with concomitant retinal pathology and insufficient clinical/imaging data. OCT imaging characteristics collected included PED type, central macular thickness (CMT), subfoveal choroidal thickness (SFCT), inner choroidal (IC) thickness, and Haller’s layer (HL) thickness. Quantitative imaging data was obtained by using caliper tools available on OCT machines.
Results :
12 eyes with CSCR and PED from 10 patients were included in this study. In the group receiving treatment, two eyes were treated with anti-VEGF injection, two eyes with photodynamic therapy (PDT), and one eye with a mineralocorticoid receptor antagonist. The baseline mean age of patients was 50.1 years±10.1, with nine males and one female. 11 PEDs were classified as serous PED, and 1 was classified as flat irregular PED (FIPED). Mean logMAR BCVA improved from 0.35 (20/45 Snellen) to 0.15 (20/28 Snellen) across the cohort, from 0.54 (20/69 Snellen) at baseline to 0.05 (20/22 Snellen) at year 3 in the treatment group, and from 0.26 (20/36 Snellen) to 0.21 (20/32 Snellen) at year 3 in the observation group. Across all eyes, mean PED height decreased from 145.2µm±148.9 at baseline to 72.25µm±108.1 at year 3, mean PED width decreased from 583.8µm±389.3 at baseline to 502.9µm±490.7 at year 3, with four PEDs resolving entirely.
Conclusions :
In this three-year study analyzing PED outcomes in CSCR, mean CMT and all choroidal parameters (SFCT, IC, HL) decreased. PED dimensions decreased to a greater extent in the observation group than in the treatment group. Future studies of a larger sample size to compare treatment vs observation will be necessary for further insights, as well as variations based on PED composition.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.