Prevalence and Morphologic Biomarkers of Metamorphopsia in Eyes With “Resolved” Chronic Central Serous Chorioretinopathy

Abstract

Purpose: To assess relationships between demographics, clinical characteristics, and optical coherence tomography characteristics with persistence of metamorphopsia after resolution of subretinal fluid in eyes with chronic central serous chorioretinopathy. Methods: One-hundred participants with “resolved” (absence of subretinal fluid) chronic central serous chorioretinopathy were retrospectively analyzed. Patients underwent a complete ophthalmologic evaluation, including assessment of the presence of metamorphopsia. At the study visit, optical coherence tomography scans were reviewed for qualitative and quantitative features. Results: Sixty-six of 100 patients (66.0%) complained of metamorphopsia. Both the foveal and parafoveal ganglion cell complex thicknesses were thinner in central serous chorioretinopathy eyes with metamorphopsia (35.1 ± 10.6 µm and 82.0 ± 18.1 µm vs. 40.7 ± 11.8 µm and 93.1 ± 13.5 µm, P = 0.030 and P < 0.0001). In the foveal region, the outer plexiform layer and outer nuclear layer thicknesses were thinner in patients with metamorphopsia (24.6 ± 8.5 µm and 63.1 ± 20.9 µm vs. 29.1 ± 8.7 and 76.2 ± 18.2 µm, P = 0.016 and P = 0.005). The ellipsoid zone band was more frequently discontinued in eyes with metamorphopsia (56.1% vs. 35.3%, P = 0.039). Multivariate stepwise linear regression analysis demonstrated that the strongest associations with the presence of metamorphopsia were with parafoveal ganglion cell complex thickness (P = 0.004), foveal outer nuclear layer thickness (P = 0.010), and number of previous recurrences of subretinal fluid accumulation (P = 0.017). The time interval from the last subretinal fluid resolution was not associated with the presence of metamorphopsia. Conclusion: In “resolved” central serous chorioretinopathy, clinical aspects (i.e., number of previous recurrences) and structural changes (i.e., ganglion cell complex and outer nuclear layer thinning) are associated with metamorphopsia after subretinal fluid resolution.

Pushing Retinal Imaging Forward: Innovations and Their Clinical Meaning – The 2022 Ophthalmologica Lecture

“…CSC is a common disease usually affecting the working-age population and typically characterized by idiopathic accumulation of sub-RPE and subretinal fluid [94–96]. While the acute form of CSC is notable for a self-limited course with spontaneous resolution of fluid and an excellent prognosis [97], the chronic form of CSC can be complicated by persistent fluid and the development of MNV [98], cystoid macular degeneration [99], and large regions of RPE atrophy [100, 101]. These factors may portend a worse visual prognosis and can occur even after the resolution of subretinal fluid (“resolved” CSC) [102].…”