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Bhattacharyya S, Saurabh K, Das S, Gorhe S, D'souza Z, Roy R. Presentation and outcome of central serous chorioretinopathy with and without pachychoroid. Eye (Lond) 2024; 38:127-131. [PMID: 37369762 PMCID: PMC10764852 DOI: 10.1038/s41433-023-02645-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 05/18/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The present study compared clinical features and outcomes of central serous chorioretinopathy (CSC) with and without pachychoroid. METHODS It was a retrospective, longitudinal, record-based study which included eyes with CSC. Patients underwent spectral domain optical coherence tomography and differentiated between pachychoroid and non-pachychoroid groups. Eyes were divided into pachychoroid and non-pachychoroid groups based on the subfoveal choroidal thickness of 300 microns and the presence of pachyvessels. RESULTS A total of 250 eyes of 250 patients were divided into pachychoroid and non-pachychoroid with 125 eyes in each group. Mean ages of patients in pachychoroid and non-pachychoroid groups were 45.7 ± 9.4 years and 47.4 ± 10.2 years, respectively. Mean initial best-corrected visual acuity (BCVA) was 0.40 ± 0.42 in pachychoroid and 0.39 ± 0.38 in non-pachychoroid group (p = 0.9). Mean final BCVA was 0.37 ± 0.9 in pachychoroid and 0.21 ± 0.33 in non-pachychoroid group (p = 0.04). 36 (28.8%) eyes in pachychoroid and 60 (48%) eyes in non-pachychoroid group had spontaneous resolution of CSC (p = 0.007). A total of 39 (31.2%) eyes in pachychoroid and 13 (10.4%) in non-pachychoroid group had recurrent CSC at the end of follow-up. CONCLUSION CSC eyes with pachychoroid had more recurrent episodes and less spontaneous resolution compared to CSC eyes in non-pachychoroid group. Final visual acuity was worse in eyes with CSC and pachychoroid. These findings need to be validated in a larger sample size with a prospective study design.
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Affiliation(s)
- Sampurna Bhattacharyya
- Aditya Birla Sankara Nethralaya, 147, Mukundapur, E. M. Bypass, Kolkata, 700 099, West Bengal, India
| | - Kumar Saurabh
- Netralayam, 330 Mukundapur Main Road, E. M. Bypass, Kolkata, 700 099, India
| | - Sudipta Das
- Netralayam, 330 Mukundapur Main Road, E. M. Bypass, Kolkata, 700 099, India
| | - Sukanya Gorhe
- Aditya Birla Sankara Nethralaya, 147, Mukundapur, E. M. Bypass, Kolkata, 700 099, West Bengal, India
| | - Zubin D'souza
- Aditya Birla Sankara Nethralaya, 147, Mukundapur, E. M. Bypass, Kolkata, 700 099, West Bengal, India
| | - Rupak Roy
- Aditya Birla Sankara Nethralaya, 147, Mukundapur, E. M. Bypass, Kolkata, 700 099, West Bengal, India.
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Liu P, Fang H, An G, Jin B, Lu C, Li S, Yang F, Du L, Jin X. Chronic Central Serous Chorioretinopathy in Elderly Subjects: Structure and Blood Flow Characteristics of Retina and Choroid. Ophthalmol Ther 2024; 13:321-335. [PMID: 37966697 PMCID: PMC10776535 DOI: 10.1007/s40123-023-00849-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 10/30/2023] [Indexed: 11/16/2023] Open
Abstract
INTRODUCTION With advancements in imaging technology, researchers have been able to identify more distinctive imaging features of central serous chorioretinopathy (CSC). However, existing research primarily concentrates on young patients aged 50 years and below, leaving a dearth of studies on elderly CSC patients. Previous studies indicate that elderly CSC patients may exhibit unique imaging characteristics and have a clinical prognosis that significantly differs from younger patients. This study aimed to evaluate the characteristics of retina, choroid structure, and blood flow in elderly patients with chronic CSC (cCSC) examined multimode imaging and try to find new pathogenesis information of it. METHODS Using a cut-off age of 50 years, patients with chronic central serous chorioretinopathy were divided into two groups: older and younger. The control group consisted of 40 healthy individuals, with their right eyes assigned. Various clinical features were recorded, including the incidence of ellipsoid zone rupture (EZ-), fibrin in the subretinal fluid (SRF), pachydrusen, subretinal drusenoid deposits (SDD), pigment epithelial detachment (PED), double-layer sign (DLS), and choroidal lipid globule cavern. Measurements were taken for the thickness of the outer nuclear layer (ONL), the length of the extended outer photoreceptor segment (POS), the height and width of SRF, the vascular density of each layer of the retinal capillary plexus, the central macular thickness (CMT), and the subfoveal choroidal thickness (SFCT). RESULTS The proportion of females in the elderly group (43.75%) was significantly higher than that in the youth group (22.41%) (p = 0.034). The degree of hyperopia in the elderly group (1.03 ± 0.73) was higher than that in the youth group (0.26 ± 1.06), with a significant difference in BCVA (p = 0.05). The thickness of SFCT, CMT, ONL in the elderly group, and the length of photoreceptor outer segment in the elderly group were thinner than those in the youth group (p < 0.05). Choroidal capillary perfusion area (CCPA), macular area, and paramacular area were lower in the elderly group than those in the youth group in the full scan range (p < 0.05). The blood flow densities of deep capillary plexus (DCP), intermediate capillary plexus (ICP), and superficial capillary plexus (SCP) in the whole scan range, macular area, and paramacular area were lower in the elderly group than in the youth group, but the differences were not statistically significant. CONCLUSIONS In conclusion, our data suggest that elderly patients with cCSC may experience different disease outcomes. Elderly cCSC patients exhibit less gender bias, poorer vision, more severe structural damage and ischemia in the choroid and retina, and have a higher risk of developing choroidal neovascularization.
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Affiliation(s)
- Pei Liu
- Department of Ophthalmology, First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, China
- Henan Eye Hospital, Zhengzhou, 450000, China
- Academy of Medical Science of Zhengzhou University, Zhengzhou, 450000, China
| | - Haixin Fang
- Department of Ophthalmology, First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, China
- Henan Eye Hospital, Zhengzhou, 450000, China
- Academy of Medical Science of Zhengzhou University, Zhengzhou, 450000, China
| | - Guangqi An
- Department of Ophthalmology, First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, China
- Henan Eye Hospital, Zhengzhou, 450000, China
- Academy of Medical Science of Zhengzhou University, Zhengzhou, 450000, China
| | - Bo Jin
- Department of Ophthalmology, First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, China
- Henan Eye Hospital, Zhengzhou, 450000, China
- Academy of Medical Science of Zhengzhou University, Zhengzhou, 450000, China
- Fundus Disease Institute of Zhengzhou University, Zhengzhou, 450000, China
| | - Chenyu Lu
- Department of Ophthalmology, First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, China
- Henan Eye Hospital, Zhengzhou, 450000, China
- Academy of Medical Science of Zhengzhou University, Zhengzhou, 450000, China
| | - Shu Li
- Department of Ophthalmology, First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, China
- Henan Eye Hospital, Zhengzhou, 450000, China
- Academy of Medical Science of Zhengzhou University, Zhengzhou, 450000, China
| | - Fan Yang
- Department of Ophthalmology, First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, China
- Henan Eye Hospital, Zhengzhou, 450000, China
- Academy of Medical Science of Zhengzhou University, Zhengzhou, 450000, China
| | - Liping Du
- Department of Ophthalmology, First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, China.
- Henan Eye Hospital, Zhengzhou, 450000, China.
- Academy of Medical Science of Zhengzhou University, Zhengzhou, 450000, China.
- Fundus Disease Institute of Zhengzhou University, Zhengzhou, 450000, China.
| | - Xuemin Jin
- Department of Ophthalmology, First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450000, China.
- Henan Eye Hospital, Zhengzhou, 450000, China.
- Academy of Medical Science of Zhengzhou University, Zhengzhou, 450000, China.
- Fundus Disease Institute of Zhengzhou University, Zhengzhou, 450000, China.
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Zhou X, Komuku Y, Araki T, Terasaki H, Miki A, Kuwayama S, Nishi T, Kinoshita T, Gomi F. Risk factors and characteristics of central serous chorioretinopathy with later development of macular neovascularisation detected on OCT angiography: a retrospective multicentre observational study. BMJ Open Ophthalmol 2022; 7:bmjophth-2022-000976. [PMID: 35537029 PMCID: PMC9016399 DOI: 10.1136/bmjophth-2022-000976] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/23/2022] [Indexed: 12/15/2022] Open
Abstract
Objective To identify the risk factors and characteristics of central serous chorioretinopathy (CSC) with subsequent macular neovascularisation (MNV) detected on optical coherence tomography angiography (OCTA). Methods and analysis We included patients from six institutions who were initially diagnosed with CSC and subsequently did or did not develop MNV detected by OCTA. Potential influencing factors were identified by evaluating the patients’ baseline demographics, multimodal fundus imaging, treatment options, recurrence and outcomes in both groups. Results We enrolled 176 eyes in 152 patients (112 men, 40 women; mean age: 52.1±10.4 years) with a mean follow-up of 30.4±16.3 months. Secondary MNV was present in 23 eyes (13.1%), and non-MNV was observed in 153 eyes (86.9%) by OCTA. Multivariate analysis revealed that older age (OR 1.06; 95% CI 1.01 to 1.11; p=0.014), chronic CSC (OR 3.05; 95% CI 1.12 to 8.30; p=0.029), leakage sites within the fovea on fluorescein angiography (OR 7.60; 95% CI, 1.89 to 30.48; p=0.004) and recurrent fluid within the first year (OR 5.12; 95% CI 1.66 to 15.77; p=0.012) were risk factors for subsequent MNV. Moreover, eyes with CSC complicated with MNV were characterised by poor visual acuity and low complete fluid resolution rates. Conclusion The factors associated with MNV secondary to CSC were older age, higher rates of chronic CSC and recurrence, and foveal leakage points on fluorescein angiography.
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Affiliation(s)
- Xiaoyin Zhou
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
- Japan Clinical Retina Study (JCREST) group, Kagoshima, Kagoshima, Japan
| | - Yuki Komuku
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
- Japan Clinical Retina Study (JCREST) group, Kagoshima, Kagoshima, Japan
| | - Takashi Araki
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
- Japan Clinical Retina Study (JCREST) group, Kagoshima, Kagoshima, Japan
| | - Hiroto Terasaki
- Japan Clinical Retina Study (JCREST) group, Kagoshima, Kagoshima, Japan
- Department of Ophthalmology, Kagoshima University, Kagoshima, Kagoshima, Japan
| | - Akiko Miki
- Japan Clinical Retina Study (JCREST) group, Kagoshima, Kagoshima, Japan
- Department of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Soichiro Kuwayama
- Japan Clinical Retina Study (JCREST) group, Kagoshima, Kagoshima, Japan
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Tomo Nishi
- Japan Clinical Retina Study (JCREST) group, Kagoshima, Kagoshima, Japan
- Department of Ophthalmology, Nara Medical University, Kashihara, Nara, Japan
| | - Takamasa Kinoshita
- Japan Clinical Retina Study (JCREST) group, Kagoshima, Kagoshima, Japan
- Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan
| | - Fumi Gomi
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
- Japan Clinical Retina Study (JCREST) group, Kagoshima, Kagoshima, Japan
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Bousquet E, Torres-Villaros H, Provost J, Elalouf M, Gigon A, Mantel I, Timsit A, Behar-Cohen F. Clinical Characteristics and Multimodal Imaging Findings of Central Serous Chorioretinopathy in Women versus Men. J Clin Med 2022; 11:jcm11061706. [PMID: 35330031 PMCID: PMC8954406 DOI: 10.3390/jcm11061706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/08/2022] [Accepted: 03/18/2022] [Indexed: 02/01/2023] Open
Abstract
(1) The aim of this study was to compare the clinical characteristics and multimodal imaging findings of central serous chorioretinopathy (CSCR) between women and men. (2) Women and men with CSCR were compared in terms of their age and risk factors, the clinical form of their disease, multimodal imaging findings and the presence of macular neovascularization (MNV) on optical coherence tomography (OCT)-angiography. (3) Results: The data of 75 women and 75 men were compared. The women were significantly older than the men (52.2 years versus 45.7 years; p < 0.001). Corticosteroid intake was more frequent in the women (56% versus 40%; p = 0.05). The women had a single foveal subretinal detachment more often than the men (73.3% versus 46.9%; p < 0.001) and they often had fewer gravitational tracks (16.3% versus 29.6%; p = 0.03). On mid-phase indocyanine green angiography, hyperfluorescent plaques were detected less often in the women than in the men (48% versus 72.2%, p = 0.001). MNV was detected on OCT-angiography in 35.9% of the women and in 13.3% of the men (p = 0.004). (4) In the women, CSCR occurs at an older age, is more often unifocal foveolar, and is associated with a higher rate of MNV. The reasons for these gender-related differences remain to be determined.
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Affiliation(s)
- Elodie Bousquet
- Department of Ophthalmology, Ophtalmopôle, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP, Université de Paris, 75014 Paris, France; (H.T.-V.); (J.P.); (A.T.); (F.B.-C.)
- Centre de Recherche des Cordeliers, Université de Paris, 75006 Paris, France
- Correspondence: ; Tel.: +33-1-5841-2215
| | - Héloïse Torres-Villaros
- Department of Ophthalmology, Ophtalmopôle, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP, Université de Paris, 75014 Paris, France; (H.T.-V.); (J.P.); (A.T.); (F.B.-C.)
| | - Julien Provost
- Department of Ophthalmology, Ophtalmopôle, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP, Université de Paris, 75014 Paris, France; (H.T.-V.); (J.P.); (A.T.); (F.B.-C.)
| | - Martine Elalouf
- Department of Ophthalmology, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, University of Lausanne, 1015 Lausanne, Switzerland; (M.E.); (A.G.); (I.M.)
| | - Anthony Gigon
- Department of Ophthalmology, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, University of Lausanne, 1015 Lausanne, Switzerland; (M.E.); (A.G.); (I.M.)
| | - Irmela Mantel
- Department of Ophthalmology, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, University of Lausanne, 1015 Lausanne, Switzerland; (M.E.); (A.G.); (I.M.)
| | - Aurélie Timsit
- Department of Ophthalmology, Ophtalmopôle, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP, Université de Paris, 75014 Paris, France; (H.T.-V.); (J.P.); (A.T.); (F.B.-C.)
| | - Francine Behar-Cohen
- Department of Ophthalmology, Ophtalmopôle, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP, Université de Paris, 75014 Paris, France; (H.T.-V.); (J.P.); (A.T.); (F.B.-C.)
- Centre de Recherche des Cordeliers, Université de Paris, 75006 Paris, France
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