Risk factors and characteristics of central serous chorioretinopathy with later development of macular neovascularisation detected on OCT angiography: a retrospective multicentre observational study

Abstract

ObjectiveTo 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 analysisWe 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.ResultsWe 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.ConclusionThe factors associated with MNV secondary to CSC were older age, higher rates of chronic CSC and recurrence, and foveal leakage points on fluorescein angiography.

Two-year outcome of half-time photodynamic therapy for chronic central serous chorioretinopathy with and without choroidal neovascularization

“…The rate of CNV (23.8%; 21 out of 88 eyes) in the present study was comparable with those reported by previous reports (15.6% and 34.5%) [ 14 , 15 ]. A previous study [ 12 ] compared CSC eyes with and without CNV and demonstrated that there were significant differences in BCVA but not in age.…”

“…Previous studies have reported choroidal neovascularization (CNV) in CSC eyes [ 11 ], with an incidence ranging from 15.6% to 34.5% [ 12 , 13 ]. Older age, cCSC, and foveal leakage points on fluorescein angiography were reported as contributive factors in the later development of CNV in CSC eyes [ 14 ]. Several studies have reported PDT treatment for CNV in CSC eyes [ 15 – 19 ].…”

The Association Between Circulating Sex Hormones and Central Serous Chorioretinopathy: A Case-Control Study

“…7 In addition, increased age, steroid use, pregnancy, post-traumatic stress disorder, antipsychotics (anti-anxiety or antidepressants), smoking and psychological stress promote the incidence of CSC. 5,[8][9][10][11] There are also local risk factors for CSC incidence. Local corticosteroid use could affect the choroidal function and thus promote the incidence or progression of CSC.…”

A multicentre study of the risk factors associated with recurrence of central serous chorioretinopathy

“…Furthermore, according to our prior study (Zhou et al. 2022) and a recent study, recurrent CSC episodes can lead to secondary macular neovascularization (MNV) and a subsequent poor prognosis (Yeo et al. 2020).…”

“…Nevertheless, the research concerning the association between CSC recurrence and risk factors, including the morphologic characteristics of the retina and choroid and patients' clinical characteristics and living habits, has rarely been addressed, and the research is not yet comprehensive. Furthermore, according to our prior study (Zhou et al 2022) and a recent study, recurrent CSC episodes can lead to secondary macular neovascularization (MNV) and a subsequent poor prognosis (Yeo et al 2020). Therefore, increasing our awareness of the risk factors for recurrence of CSC has pivotal relevance for early detection, intensive treatment and promoting disease management.…”