Short Term Presence of Subretinal Fluid in Central Serous Chorioretinopathy Affects Retinal Thickness and Function.

Maciej Gawęcki,Agnieszka Jaszczuk,Andrzej Grzybowski

doi:10.3390/jcm9113429

Abstract

Background: Acute central serous chorioretinopathy (CSCR), with subretinal fluid (SRF) resolving spontaneously within a few months from disease onset, has been considered as a benign and self-limiting disease for many years. This study sought to discover if a short presence of SRF can result in morphological and functional damage to the retina. Materials and methods: The study included patients treated by subthreshold diode micropulse laser (SDM) application for acute CSCR at the Dobry Wzrok Ophthalmological Clinic between January 2018 and November 2019. Inclusion criteria were: first episode of CSCR; duration of symptoms of two months or less; complete resolution of subretinal fluid (SRF) after a single session of SDM; and a lack of any retinal pathology, previous CSCR episode, significant anisometropia or amblyopia in the collateral eye. Fifteen patients fulfilled the inclusion criteria, including 13 males and two females aged 42.3 ± 9.5 years. The mean duration of symptoms before treatment was 4.7 ± 1.3 weeks on average. Baseline and follow-up examinations were performed in both the affected and collateral eyes and included best-corrected visual acuity (BCVA); spectral-domain optical coherent tomography measurements such as central retinal thickness (CRT) and minimal foveal thickness (MFT) (at the follow-up visit only); fluorescein angiography (at presentation only) and fundus autofluorescence. The first follow-up visit, when the total resolution of SRF was noted, was conducted between 8 and 12 weeks after SDM. Results: Resolved CSCR eyes had significantly poorer BCVA, CRT, and MFT findings in comparison with healthy collateral eyes (respectively, 0.11 +/− 0.1 vs. 0.01 +/− 0.04 logMAR; 238.80 +/− 23.39 vs. 264.87 +/− 21.22 µm and 178.93 +/− 16.88 vs. 199.47 +/− 17.87 µm) despite the short period of CSCR duration (maximum of 14 ± 2.15 weeks on average). Conclusion: Short presence of SRF typical for acute CSCR can affect retinal function and morphology resulting in poorer visual outcome.

Highlights

This retrospective study sought to determine whether the short term presence of subretinal fluid (SRF), typical for resolving acute form of central serous chorioretinopathy (CSCR), results in functional or morphological damage to the retina
The aim of the study was not to analyze the efficacy of subthreshold diode micropulse laser (SDM) treatment in CSCR, but to evaluate the morphological and functional alterations in the retina that occur after short term presence of subretinal fluid
The study group consisted of cases with resolved CSCR, ruled as such when the total resorption of SRF was observable

Summary

Introduction

This retrospective study sought to determine whether the short term presence of subretinal fluid (SRF), typical for resolving acute form of central serous chorioretinopathy (CSCR), results in functional or morphological damage to the retina. It is widely acknowledged that the chronic form of CSCR can result in permanent and significant damage to the retina, expressed as a loss of photoreceptors, retinal thinning, and impaired visual acuity. Acute central serous chorioretinopathy (CSCR), with subretinal fluid (SRF) resolving spontaneously within a few months from disease onset, has been considered as a benign and self-limiting disease for many years. Inclusion criteria were: first episode of CSCR; duration of symptoms of two months or less; complete resolution of subretinal fluid (SRF) after a single session of SDM; and a lack of any retinal pathology, previous CSCR episode, significant anisometropia or amblyopia in the collateral eye. Conclusion: Short presence of SRF typical for acute CSCR can affect retinal function and morphology resulting in poorer visual outcome

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