Correlation between baseline retinal microstructures in spectral-domain optic coherence tomography and need for early intervention in central serous chorioretinopathy

Abstract

PurposeTo investigate the association between baseline retinal microstructures observed with spectral-domain optical coherence tomography (OCT) and the need for early intervention in central serous chorioretinopathy (CSC).MethodsCases of acute CSC from July 2011 to December 2014 were retrospectively reviewed. OCT images were further classified using six parameters: foveal serous retinal detachment; pigment epithelial detachment; fibrinous exudates in the subretinal space; retinal pigment epithelium bumps; thickened outer retinal layer and hyper-reflective dots in the intraretinal and/or subretinal layer. Correlation among these parameters and the need for intervention was analysed. Receiver operating characteristic (ROC) curves were performed to identify the optimal number of parameters for prediction.ResultsA total of 47 eyes from 47 patients were included. Among these, 25 eyes required treatment. The presence of subretinal hyper-reflective dots was the only OCT factor having significant association with the need for intervention. An ROC curve analysis revealed that the optimal cut-off value (Youden index) was achieved when combining subretinal hyper-reflective dots with aged ≥50 years and female sex for analysis (area under the curve, 0.735; Youden index: 0.425).ConclusionThe presence of subretinal/intraretinal hyper-reflective dots observed with OCT, female and aged ≥50 years might help predict the need for early intervention in acute CSC.

Factors influencing the episode duration and the anatomical and functional outcome in cases of acute central serous chorioretinopathy

“… 16 30 31 The overall incidence of HRDs in our study was 35.48%. This is relatively low compared with the incidence rate of 66%, 65%, 57.4% and 50% in the studies by Yalcinbayir et al , 16 Maruko et al , 29 Lai et al 18 and Suwal et al 32 , respectively. Lee et al 17 stated that increased number of HRDs was associated with recurrences.…”

“…However, there are studies that have reported that women of age ≥50 take longer time for disease resolution 35 and is an indication for early intervention. 18 Daruich et al 33 found that age ≥40 years was an independent factor associated with longer disease duration, but Lee et al 17 found no relation between duration of SRF resolution and duration of visual acuity recovery with the age of the patient.…”

<p>Baseline Predictive Factors of Visual Outcome and Persistence of Subretinal Fluid Based on Morphologic Changes in Spectral Domain Optical Coherence Tomography in Patients with Idiopathic Central Serous Chorioretinopathy</p>

“…Hyper-reflective dots when present in intraretinal or subretinal layer have been correlated with lower final BCVA 3,16,18,19. Also, they were found to be the only OCT parameter associated with the non-resolution of SRF 20…”

Management of chronic central serous chorioretinopathy

“…completed a retrospective study of patients with acute CSC that investigated multiple structural parameters important for prognosis. [ 50 ] It was concluded that the presence of subretinal and intraretinal hyperreflective dots indicated the need for early intervention. Furthermore, it was suggested that both female and patients agents aged > 50 years also benefited from early treatment.…”