RECENT PUBLICATIONS

REGRESSION PATTERNS OF CENTRAL SEROUS CHORIORETINOPATHY USING EN FACE OPTICAL COHERENCE TOMOGRAPHY

2022 Mar 31

Supriya Arora, Brian Rosario, Abdul Rasheed Mohammed, Oliver Beale, Amrish Selvam, Ramesh Venkatesh, Dmitrii S Maltsev, Jay Chhablani, on behalf of Central Serous Chorioretinopathy Study Group

​

Purpose: To study the regression patterns of subretinal fluid (SRF) in central serous chorioretinopathy (CSCR) on sequential en face optical coherence tomography (OCT) and its relationship to leak locations.

Methods: Retrospective study on patients with acute CSCR. Inclusion criteria were (i) availability of data, sequential OCT and OCT angiography (B scan and en face OCT) every 2 weeks until resolution of SRF or 6 months, whichever is earlier; (ii) single active leak. Exclusion criteria were (i) presence of macular neovascularization or atypical CSCR, (ii) diffuse pigment epitheliopathy, (iii) multiple leaks. Serial en face OCT scans were evaluated and the area of SRF was measured using ImageJ software. Correlation coefficient was calculated for the regression rate of SRF area and central retinal thickness (CRT) over the first month of follow-up and the time of complete SRF resolution.

Results: Out of the 25 eyes, 20 eyes demonstrated a centripetal regression, and 5 eyes demonstrated a centrifugal regression. In eyes with a leakage point <1000μ from the fovea, 86% resolved in a centripetal fashion, and in eyes with leak site ≥1000μ away from fovea, 70% eyes resolved centripetally. There was a correlation (r=-0.47, p=0.018) of the rate regression of SRF area during the first month and timing of resolution. In contrast, this correlation was absent (r=-0.16, p=0.44) for CRT regression.

Conclusion: Our en face-based analysis of sequential OCTs of regressing CSCR demonstrated a tendency for the subfoveal SRF to resolve towards the end or a centripetal pattern of regression. Prediction of resolution of SRF at 1 month is better with en face area of SRF in comparison to CRT.

LONGITUDINAL FOLLOW-UP AND OUTCOME ANALYSIS IN CENTRAL SEROUS CHORIORETINOPATHY

2022 April 1

Niroj Kumar Sahoo, Joshua Ong, Amrish Selvam, Dmitri Maltsev, Riccardo Sacconi, Ramesh Venkatesh, Nikitha Gurram Reddy, Shivam Madan, Beatrice Tombolini, Luiz H. Lima, Varsha Pramil, Giridhar Anantharaman, Antonio Marcelo Casella, Gerardo Ledesma-Gil, Nadia Waheed, Enrico Borrelli, Giuseppe Querques & Jay Chhablani 

​

Objectives

To analyse the longitudinal changes in visual acuity and risk factors for recurrence or development of choroidal neovascularisation (CNV) in eyes with acute or chronic central serous chorioretinopathy (CSCR).

Methods

This was a retrospective, multicentric, longitudinal, observational study done in patients with a diagnosis of unilateral or bilateral CSCR and having at least 4 years of follow-up between the years 1999 and 2020. Kaplan–Meier curves were used for assessing cumulative risks. Multivariate logistic, linear and cox regression models were used for risk factor analyses. The trend in visual acuity, cumulative risks of recurrence and CNV formation was analysed.

Results

A total of 117 out of 175 eyes (66.8%) had stable or improvement in vision at last follow-up, while 24 eyes had more than/equal to 3 line loss of vision. Four eyes (7.7%) with acute CSCR at initial presentation developed features of chronic CSCR at the final presentation. Thirty-seven eyes had recurrence during the follow-up with a 10-year cumulative recurrence rate of around 30%. On Cox proportional hazard regression analysis, history of previous treatment and male gender (p = 0.03) were associated with a lower risk of recurrence. Twenty-four developed de novo CNV by the end of follow-up and higher age (p = 0.001) and a higher number of recurrences (p = 0.05) were associated with a higher risk of early de novo CNV formation. The cumulative 10-year CNV development rate was 17.4%.

Conclusion

A non-temporal relationship between acute and chronic CSCR was seen. Previous treatment, smoking and baseline RPE abnormality affected recurrence of SRF or CNV formation.