Evaluation of Predictive Factors Associated with Resolution of Acute Central Serous Chorioretinopathy

Ahmed Yousef Amin

Ophthalmology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

Mohamed Hosny El-Bradey

Ophthalmology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

Yasser Ragab Serag

Ophthalmology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

Magdy Salah Moussa

Ophthalmology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

*Author to whom correspondence should be addressed.


Abstract

Background: Central serous Chorioretinopathy (CSC) is characterized by serous subretinal fluid (SRF)leakage and accumulation with subsequent serous retinal detachment We conducted this study to study the predictive factors associated with resolution of the non-treated, first episode of acute CSC including systemic factors and ocular factors using different imaging modalities.

Methods: This prospective, observational study of 30 affected eyes and 30 fellow eyes of 30 consecutive patients with non-treated, first episode of acute CSC and age and sex matched control group of 30 eyes were also studied. Detailed history taking including: name, age, residence, previous and present ocular or systemic diseases, previous ocular trauma, previous ocular surgery, assessment of systemic factors including, smoking, hypertension, Helicobacter pylori infection, pregnancy, sleeping disturbance, autoimmune diseases and psychological factors, history of intake of ocular or systemic medications especially corticosteroid and psychopharmacological medications, best corrected visual acuity (BCVA).

Results: The baseline BCVA of the "Improvement" group was lower than that of "No Improvement" group and the difference was statistically significant (p. value 0.014*). On the other hand, the final BCVA of the "Improvement" group was higher than that of "No Improvement" group and the difference was also statistically significant (p. value 0.005*). There was a statistically significant decrease of the mean automated central retinal thickness (ACRT) (P-value 0.004*), mean vertical SRF dimension (VD) (P-value 0.012*), mean horizontal SRF dimension (HD) (P-value 0.022*) and mean SRF height (P-value 0.002*).

There was a statistically significant negative correlation between age (years) and the mean baseline SFCT (um) in both affected and fellow eyes (P-value 0.013* and 0.014* respectively). In other words, the older the patient was, the thinner the baseline SFCT in both eyes (affected and fellow) will be measured.

Conclusions: Proper assessment of systemic factors associated with CSC and ocular factors using multimodal ocular imaging help us in predicting the course and visual prognosis of CSC cases. We depended on evaluating the difference of all variables between the "improvement group, n=22 cases" (decreased SRF height after 3 months) and "no improvement group, n=8 cases" (persistent/increased SRF height after 3 months).

Keywords: Resolution, Central Serous Chorioretinopathy, best corrected visual acuity


How to Cite

Amin, A. Y., El-Bradey, M. H., Serag, Y. R., & Moussa, M. S. (2022). Evaluation of Predictive Factors Associated with Resolution of Acute Central Serous Chorioretinopathy. Journal of Advances in Medicine and Medical Research, 34(23), 248–266. https://doi.org/10.9734/jammr/2022/v34i234860

Downloads

Download data is not yet available.

References

van Rijssen TJ, van Dijk EHC, Yzer S, Ohno-Matsui K, Keunen JEE, Schlingemann RO, et al. Central serous chorioretinopathy: Towards an evidence-based treatment guideline. Prog Retin Eye Res. 2019;73:100770.

Fine HF, Ober MD, Hariprasad SM. Current concepts in managing central serous chorioretinopathy. Ophthalmic Surg Lasers Imaging Retina. 2014;45:9-13.

Maranduca MA, Branisteanu D, Serban DN, Branisteanu DC, Stoleriu G, Manolache N, et al. Synthesis and physiological implications of melanic pigments. Oncol Lett. 2019;17:4183-7.

Lee WK, Baek J, Dansingani KK, Lee JH, Freund KB. Choroidal morphology in eyes with polypoidal choroidal vasculopathy and normal or subnormal subfoveal choroidal thickness. Retina (Philadelphia, Pa). 2016;36 Suppl 1:S73-S82.

Mrejen S, Spaide RF. Optical coherence tomography: imaging of the choroid and beyond. Surv Ophthalmol. 2013;58: 387-429.

Rahbani-Nobar MB, Javadzadeh A, Ghojazadeh L, Rafeey M, Ghorbanihaghjo A. The effect of Helicobacter pylori treatment on remission of idiopathic central serous chorioretinopathy. Mol Vis. 2011;17:99-103.

Chalisgaonkar C, Chouhan S, Lakhtakia S, Choudhary P, Dwivedi PC, Rathore MK. Central serous chorioretinopathy and endogenous cortisol - is there an association? Indian J Ophthalmol. 2010;58:449-50; author reply 50.

Tufan HA, Gencer B, Comez AT. Serum cortisol and testosterone levels in chronic central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol. 2013;251: 677-80.

Natung T, Keditsu A. Comparison of Serum Cortisol and Testosterone Levels in Acute and Chronic Central Serous Chorioretinopathy. Korean J Ophthalmol. 2015;29:382-8.

Garg SP, Dada T, Talwar D, Biswas NR. Endogenous cortisol profile in patients with central serous chorioretinopathy. Br J Ophthalmol. 1997;81:962-4.

Kapetanios AD, Donati G, Bouzas E, Mastorakos G, Pournaras CJ. [Serous central chorioretinopathy and endogenous hypercortisolemia]. Klin Monbl Augenheilkd. 1998;212:343-4.

Zakir SM, Shukla M, Simi ZU, Ahmad J, Sajid M. Serum cortisol and testosterone levels in idiopathic central serous chorioretinopathy. Indian J Ophthalmol. 2009;57:419-22.

Mudvari SS, Goff MJ, Fu AD, Mc Donald HR, Johnson RN, Ai E, et al. The natural history of pigment epithelial detachment associated with central serous chorioretinopathy. Retina. 2007;27: 1168-73.

Yannuzzi LA. Central serous chorioretinopathy: a personal perspective. Am J Ophthalmol. 2010;149:361-3.

Shahin MM. Angiographic characteristics of central serous chorioretinopathy in an Egyptian population. Int J Ophthalmol. 2013;6:342-5.

Spitznas M, Huke J. Number, shape, and topography of leakage points in acute type I central serous retinopathy. Graefes Arch Clin Exp Ophthalmol. 1987;225:437-40.

How AC, Koh AH. Angiographic characteristics of acute central serous chorioretinopathy in an Asian population. Ann Acad Med Singap. 2006;35:77-9.

Zhang P, Wang HY, Zhang ZF, Sun DJ, Zhu JT, Li J, et al. Fundus autofluorescence in central serous chorioretinopathy: association with spectral-domain optical coherence tomography and fluorescein angiography. Int J Ophthalmol. 2015;8:1003-7.

Missotten TO, Hoddenbach JG, Eenhorst CA, van den Born LI, Martinez Ciriano JP, Wubbels RJ. A randomized clinical trial comparing prompt photodynamic therapy with 3 months observation in patients with acute central serous chorioretinopathy with central macular leakage. Eur J Ophthalmol. 2021;31:1248-53.

Imamura Y, Fujiwara T, Margolis R, Spaide RF. Enhanced depth imaging optical coherence tomography of the choroid in central serous chorioretinopathy. Retina. 2009;29:1469-73.

Yang L, Jonas JB, Wei W. Optical coherence tomography-assisted enhanced depth imaging of central serous chorioretinopathy. Invest Ophthalmol Vis Sci. 2013;54:4659-65.

Goktas A. Correlation of subretinal fluid volume with choroidal thickness and macular volume in acute central serous chorioretinopathy. Eye (Lond). 2014;28: 1431-6.

Zhou H, Dai Y, Shi Y, Russell JF, Lyu C, Noorikolouri J, et al. Age-Related Changes in Choroidal Thickness and the Volume of Vessels and Stroma Using Swept-Source OCT and Fully Automated Algorithms. Ophthalmol Retina. 2020;4: 204-15.

Karahan E, Zengin MO, Aydin R, Ozturk T, Kaya M, Kocak N, et al. Correlation of choroidal thickness with serum cortisol level. Clin Exp Optom. 2015;98:362-5.

Cakir B, Reich M, Lang S, Bühler A, Ehlken C, Grundel B, et al. OCT Angiography of the Choriocapillaris in Central Serous Chorioretinopathy: A Quantitative Subgroup Analysis. Ophthalmol Ther. 2019;8:75-86.

Wang Z, Xin Z, Yang J, Lu H, Wang H, Zhu L. Choriocapillaris Ischemia at the Leakage Point of Patients With Acute Central Serous Chorioretinopathy. Frontiers in Medicine. 2021;8.

Han KJ, Kim HJ, Woo JM, Min JK. Comparison of Retinal Layer Thickness and Capillary Vessel Density in the Patients with Spontaneously Resolved Acute Central Serous Chorioretinopathy. J Clin Med. 2020;10.

Lu H, Wang Z, Xin Z, Yang J. To evaluate the microcirculation of retinochoroid capillary between acute and chronic central serous chorioretinopathy with OCTA. Medicine (Baltimore). 2021;100: e27069.

Nicolò M, Rosa R, Musetti D, Musolino M, Saccheggiani M, Traverso CE. Choroidal Vascular Flow Area in Central Serous Chorioretinopathy Using Swept-Source Optical Coherence Tomography Angiography. Investigative Ophthalmology & Visual Science. 2017; 58:2002-10.