Clinical and imaging characteristics of central serous chorioretinopathy with subfoveal leak

Abstract

Purpose : To analyze the longitudinal changes in visual and imaging parameters, and factors predicting visual acuity in eyes with central serous chorioretinopathy (CSCR) with subfoveal leak.

Methods : This was a retrospective, multicentric, longitudinal, observational study in patients with a diagnosis of CSCR with subfoveal leak. Trend in best-corrected visual acuity (BCVA), central macular thickness (CMT), choroidal thickness (CT), Haller vessel thickness, Inner choroidal thickness, were analyzed. Factors affecting visual acuity at 6 months and 1 year were also analyzed.

Results : A total 143 eyes of 140 patients (117 males and 23 females) with a mean age 49.7±10.9 years, were included. The median duration of symptoms before presentation was 2 months (IQR 0.5 to 42.6 months). The leak was sub-foveal in 52 eyes, and juxta-foveal / extrafoveal in 71 eyes. The duration of symptoms was significantly higher in eyes with extrafoveal /juxtafoveal leak [median=180days (IQR 46-1825 days)], than those with subfoveal leak [Median=19days (IQR 10-60 days)] (p=0.004). Eyes with subfoveal leak had higher inner choroidal thickness at baseline and 3 months (p=0.007), lower CMT (p=0.001) and lower Haller vessel thickness at 3 months (p=0.04). On linear regression analysis factors affecting poor visual acuity at 1 year in eyes with subfoveal leak, were an older age at presentation (p=0.01), and poor baseline BCVA (p=0.02) (although history of recurrence, PED, focal RPE defects, outer retinal defects, and IRF, at baseline and longer wait time before initiation of therapy, were associated with poor prognosis in univariate analysis).

Conclusions : CSCR with subfoveal leak presented early to clinics and had higher inner CT than those without, at baseline. Older age and poorer baseline BCVA were associated with poor BCVA at 1 year follow up.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.