Ganglion Cell Loss in the Course of Central Serous Chorioretinopathy

Abstract

Introduction: Central serous chorioretinopathy (CSCR) as a clinical entity is potentially damaging and may significantly affect retinal morphology and function, especially in the chronic form. Our study aimed to determine the amount of deficit of best corrected visual acuity (BCVA) and individual retinal layers, including ganglion cells, in different types of CSCR and with reference to its duration. Methods: The retrospective analysis included 69 eyes of patients with resolved CSCR managed in Dobry Wzrok Ophthalmological Clinic between 1 January 2019 and 30 June 2022. The diagnosis of CSCR was based on the criteria outlined by the Central Serous Chorioretinopathy International Group. The analysis included data obtained from medical history, BCVA testing, and spectral domain optical coherence tomography (SD-OCT) measurements, with specific thickness values for individual retinal layers. The results were compared among affected eyes, unaffected fellow eyes, and healthy controls.Results: BCVA values were significantly lower in acute (0.08 ± 0.12 logMAR) and chronic (0.26 ± 0.19 logMAR) cases versus controls (0.0 logMAR). The thickness of all retinal layers (central subfoveal thickness, CST; inner retina with ganglion cell complex, GC; outer retina, ORT; and photoreceptor outer segments, POS) and macular volume (MV) were significantly decreased in chronic eyes versus controls (p \ 0.01). Acute eyes had significant thinning of the outer retina and POS only compared to control eyes (p \ 0.01). The amount of deficit in CST, ORT, GC, and MV was strongly correlated with poorer BCVA (p \ 0.001), and the deficit of CST, ORT, and GC was correlated with disease duration (p \ 0.05). The subfoveal choroidal thickness was significantly greater in affected and fellow eyes versus controls (p \ 0.001). Conclusion: Damage to the outer retina and photoreceptors occurs early in the course of CSCR, with a deficit in ganglion cells noted adjunctively in chronic forms of the disease. Further studies are required to precisely determine correlation between visual loss in CSCR and deficits in individual retinal layers.

Effect of Focal Laser Photocoagulation on the Ganglion Cell Complex Thickness in Acute Central Serous Chorioretinopathy

“…However, their sample size was small (n = 7), and their study cohort included both those who underwent laser treatment (n = 3) and those who were merely observed (n = 4), and they did not elaborate on the reasons for the reduction in GCL and RNFL thickness. Two previous studies align with our findings [7,8]. Gawecki et al [8] reported no significant differences in GCL-IPL thickness between acute CSC patients (n = 13) and a normal control group, while they noted a reduced GCL-IPL thickness in chronic CSC patients compared to controls.…”

“…Two previous studies align with our findings [7,8]. Gawecki et al [8] reported no significant differences in GCL-IPL thickness between acute CSC patients (n = 13) and a normal control group, while they noted a reduced GCL-IPL thickness in chronic CSC patients compared to controls. They surmised that chronic CSC patients experience loss of both the outer retinal layers and GCL, leading to significant visual impairment [8].…”

“…Gawecki et al [8] reported no significant differences in GCL-IPL thickness between acute CSC patients (n = 13) and a normal control group, while they noted a reduced GCL-IPL thickness in chronic CSC patients compared to controls. They surmised that chronic CSC patients experience loss of both the outer retinal layers and GCL, leading to significant visual impairment [8]. Likewise, Han et al [7] examined 34 eyes with spontaneously resolved acute CSC, noting significant thinning of the outer retinal layer but an unaffected GCC layer.…”

“…A prior study showed that the GCL and RNFL thickness reduced in acute CSC as the subretinal fluid (SRF) decreased [4]; in addition, other investigations showed that the GCC thickness decreased in comparison to normal [6] or fellow eyes [9] when SRF was present. However, there have been recent reports reporting conflicting results that there is no difference in GCC thickness between resolved acute CSC eyes and normal eyes [7,8]. Additionally, to our knowledge, there has been no study that has investigated changes in GCC only in laser-treated patients with acute CSC.…”

“…Quantitative analysis is now possible because of the development of optical coherence tomography (OCT) devices, making it possible to learn more about the diagnosis and progression of ocular diseases. Since CSC is categorized as a pachychoroid spectrum disorder, most investigations to date have been on the outer retina and choroid [3][4][5], and just a few studies have been conducted on the inner retina [4,[6][7][8][9].…”