Central Serous Chorioretinopathy with Bacillary Layer Detachment

Abstract

Purpose :
Damage to the outer retina is one major cause of bacillary layer detachment (BALAD), which has been linked to several disorders. We performed a retrospective case-control study to evaluate BALAD in patients with central serous chorioretinopathy (CSC).

Methods : Charts of consecutive subjects with BALAD and CSC formed the study group. The inclusion criteria included: either gender, age above 18 years, yellowish macular discoloration beneath the neurosensory detachment by retinography, and several findings on spectral-domain optical coherence tomography (SD-OCT): a large amount of subretinal fluid, pigment epithelial detachment, ellipsoid zone detachment, inner segment splitting, hyperreflective material in the subretinal space, and increased choroidal thickness. The control group was composed of consecutive patients with CSC without BALAD, matched by gender and age. Main outcome measures included the correlation of BALAD with the following variables: history of anxiety or stress disorder, systemic hypertension or coronary artery disease, systemic corticosteroid use, prior therapy for CSC, COVID-19 infection, and % of eyes with choroidal thickness above 300 microns.

Results : The study and control groups included respectively (in percent) 34 subjects (39 eyes) and 31 subjects (39 eyes): a history of anxiety or stress disorder (5.9 vs. 5.9), systemic hypertension or coronary artery disease (23. 5 vs. 26.5), corticosteroid use (23.5 vs. 5.9), prior therapy for CSC (58.8 vs. 20.6), COVID-19 infection (8.8 vs. zero), and choroidal thickness above 300 microns (94.1 vs. 100).

Conclusions : The current comparative study suggests a role for an excessive immune and inflammatory response as responsible for BALAD in CSC.

This abstract was presented at the 2023 ARVO Imaging in the Eye Conference, held in New Orleans, LA, April 21-22, 2023.