Abstract:

Objective To evaluate the correlations between baseline morphological changes in optical coherence tomography (OCT) in patients with central serous chorioretinopathy (CSC) and their visual prognosis. Design Retrospective case series. Participants 136 patients (148 eyes) with resolved CSC in Beijing Tongren Hospital. Methods All the patients underwent routine fundus fluorescence angiography (FFA) + indocyanine green angiography (ICGA) and OCT examination using Spetralis HRA-OCT. According to the results of FFA+ICGA, the CSC patients received half dose photodynamic therapy or laser photocoagulation or micropulse photocoagulation respectively. Baseline changes of outer nuclear layer thickness in OCT were semi-automatically analyzed, and the integrity of photoreceptor layer in OCT was qualitatively analyzed. Severity of photoreceptor layer defect was defined as 4 grades: grade 0, in which the detached retina was detected in continuity with well-preserved photoreceptor layer; grade 1, in which the outer segment defects could be seen while the ellipsoid zone and myoid zone were well preserved; grade 2, in which the outer segment and the ellipsoid zone were heavy damaged and the myoid zone defects can be detected; and grade 3, in which the outer photoreceptor layer atrophy was detected. The linear mixture regression was used to analyze the relationship between macular morphologic changes in OCT and best corrected visual acuity (BCVA) at final visit. Main Outcome Measures Severity of photoreceptor layer defect, outer nuclear layer thickness, BCVA (LogMAR). Results Among 148 eyes, the severity of photoreceptor layer defect of 90 eyes was grade 0, of 29 eyes was grade 1, of 18 eyes was grade 2, and of 11 eyes was grade 3, while the percentage of them with LogMAR <0.2 at baseline was 22.3% (33 eyes), and 54.1% (80 eyes) at final visit after treatment. The results of linear mixture regression analysis showed that the severity of photoreceptor layer defect correlates to better BCVA (β=-0.242, P<0.001). Conclusion The severity of photoreceptor layer defect in CSC is the key factor correlated to better visual prognosis, and can be a biomarker that indicates the interference treatment.

Key words: central serous chorioretinopathy, optical coherence tomography, macular foveal, photoreceptor layer, outer nuclear layer