Central serous chorioretinopathy: correlation of structural changes on optical coherence tomography with visual outcomes
Anu Malik1, Alka Gupta2, Charu Mithal3, Vivek Gupta4, Yogesh K Gupta5
1 PDCR, Department of Ophthalmology, Upgraded Department of Ophthalmology, L.L.R.M. Medical College, Meerut, Uttar Pradesh, India
2 Associate Professor, Department of Ophthalmology, Upgraded Department of Ophthalmology, L.L.R.M. Medical College, Meerut, Uttar Pradesh, India
3 Head and Assistant Professor, Department of Ophthalmology, Upgraded Department of Ophthalmology, L.L.R.M. Medical College, Meerut, Uttar Pradesh, India
4 Trainee, Plastic Surgery, IPGMER & SSKM Hospital, Kolkata, West Bengal, India
5 Hindu Rao Hospital, NDMC Medical College, New Delhi, India
H. No. 584, Sri Nagar, Hapur (Panchsheel Nagar) - 245 101, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
Background The aim of this study was to describe optical coherence tomographic (OCT) patterns in patients with central serous chorioretinopathy and to correlate them with visual outcomes.
Materials and methods In a prospective case study, 20 eyes of 20 patients diagnosed ophthalmoscopically as central serous chorioretinopathy were subjected to meticulous recording of visual acuity, ophthalmologic examination, fundus photography, fluorescein angiography, and spectral-domain optical coherence tomography.
Results In the acute phase, subretinal fluid with an area of neurosensory retinal detachment was noted on OCT in all 20 eyes. OCT showed a retinal pigment epithelial (RPE) detachment corresponding to the fluorescein angiography leak site in three (15%) eyes. A total of 10 patients at the end of follow-up with no subretinal fluid had significantly lower mean foveal thickness. The logMAR best-corrected visual acuity (BCVA) improved from 0.63 (SD=0.30; range=1.00–0.18) at presentation to 0.23 (SD=0.24; range=0.78–0.00) at 6 months (P<0.05). The mean foveal retinal thickness was 346.8 µm (SD=111.87) at presentation (range=220–622) and 150.90 µm (SD=42.32) at 6 months (range=108–250) (P<0.001). Final OCT findings that associated significantly with good visual outcome (logMAR BCVA≤0.3) were preserved outer photoreceptor layer, inner and outer segment continuity, and bulging on the RPE layer/irregularity of RPE choroid band. The present study also showed no association of existent neurosensory retinal detachment with a final BCVA of logMAR BCVA of 0.3 or less (Fischer exact test, two-sided, P=0.087). No association was found between existent pigment epithelial detachment with a final BCVA of logMAR BCVA of 0.3 or less (Fischer exact test, two-sided, P=0.200).
Conclusion Structural changes on OCT may be associated with different levels of visual function, and OCT findings could be important parameters of deciding follow-up and treatment.