Abstract
Purpose To investigate the clinical characteristics of pregnancy-associated central serous chorioretinopathy (CSC) in the Chinese population. Methods The medical records of patients diagnosed with pregnancy-associated CSC from February 2012 to October 2019 were retrospectively reviewed. Best-corrected visual acuity (BCVA), symptom duration, pregnancy-related medical information, and optical coherence tomography (OCT) images were collected. Results Nine patients (11 eyes) were included. Five women were in their first pregnancy and four were in their second pregnancy, two of whom experienced CSC in their first pregnancy as well. The mean age was 35.00 ± 3.97 years. The mean symptom duration at the initial visit was 19.73 ± 13.65 days. The mean gestational age at the time of development of CSC was 27.11 ± 2.09 weeks. The mean BCVA (logarithm of the minimum angle of resolution (logMAR)) at the initial visit was 0.36 ± 0.18 (Snellen 20/45, range 20/100–20/25). All eyes showed subretinal hyperreflective fibrin on OCT images at the initial visit. Four patients (4 eyes) were lost to follow-up before fluid resolution. The mean BCVA at the final visit was logMAR 0.10 ± 0.15 (Snellen 20/25, range 20/50–20/20)). One eye in the oldest patient had persistent subretinal fluid at 26 months postpartum. The subretinal fluid resolved completely after half-dose photodynamic therapy (PDT); however, the ellipsoid zone at the fovea remained discontinuous at 30 months after half-dose PDT. The remaining six eyes all showed spontaneous resolution of subretinal fluid around delivery and regained intact ellipsoid zone. Conclusions Pregnancy-associated CSC in Chinese developed mostly in the third trimester and usually recovered spontaneously around delivery with good final visual acuity. However, patients might require long-term follow-up until complete resolution of subretinal fluid and to detect recurrences. Half-dose PDT can be administered early if there is little reduction in the amount of subretinal fluid after delivery.
Highlights
Acute central serous chorioretinopathy (CSC), a common macular disease, usually presents with a well-circumscribed serous retinal detachment at the posterior pole on clinical examination and one or more leakage points at the level of the retinal pigment epithelium (RPE) on fluorescein angiography (FA) [1]
Pregnancy-associated CSC typically develops in the third trimester and is characterized by the onset of subretinal hyperreflective fibrin, spontaneous, and complete resolution of subretinal fluid around the time of delivery and good final visual acuity [2,3,4,5,6,7,8,9,10,11,12,13,14,15,16]
Six of the 11 eyes (54.5%) showed multifocal RPE abnormal sites on optical coherence tomography (OCT). ey were all from the four elder patients with age of ≥35 y
Summary
Acute central serous chorioretinopathy (CSC), a common macular disease, usually presents with a well-circumscribed serous retinal detachment at the posterior pole on clinical examination and one or more leakage points at the level of the retinal pigment epithelium (RPE) on fluorescein angiography (FA) [1]. Morikawa et al reported on four pregnant Japanese women who developed CSC after onset of pre-eclampsia (PE) [17]. The clinical characteristics of pregnancy-associated CSC without PE in Eastern populations are not well described. Diagnosis of pregnancy-associated CSC was based on clinical presentation [2,3,4,5,6]. Rezai and Eliott demonstrated that optical coherence tomography (OCT) was useful for diagnostic and monitoring purposes in pregnant women with CSC without the risks to the fetus of exposure to fluorescein dye [7].
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