Niroj Kumar Sahoo1, Joshua Ong2, Amrish Selvam2, Dmitri Maltsev3, Riccardo Sacconi4, Ramesh Venkatesh5, Nikitha Gurram Reddy5, Shivam Madan6, Beatrice Tombolini4, Luiz H Lima7, Varsha Pramil8,9, Giridhar Anantharaman6, Antonio Marcelo Casella10, Gerardo Ledesma-Gil11,12, Nadia Waheed8, Enrico Borrelli4, Giuseppe Querques4, Jay Chhablani13. 1. Department of Retina and Vitreous, L V Prasad Eye Institute, Vijayawada, India. 2. UPMC Eye Centre, University of Pittsburgh, Pittsburgh, PA, 15213, USA. 3. Department of Ophthalmology, Military Medical Academy, St. Petersburg, Russia. 4. Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy. 5. Deptartment of Retina and Vitreous, Narayana Nethralaya, Benguluru, India. 6. Department of Vitreo-Retina, Giridhar Eye Institute, Ponneth Temple Road, Kadavanthra, Cochin, Kerala, India. 7. Department of Ophthalmology, Federal University of São Paulo/Paulista School of Medicine, São Paulo, Brazil. 8. New England Eye Center, Tufts Medical Center, Boston, MA, USA. 9. Tufts University School of Medicine, Boston, MA, USA. 10. Clinical Surgical Department, Ophthalmology, Universidade Estadual de Londrina, Londrina, Brazil. 11. Vitreous Retina Macula Consultants of New York, New York, NY, USA. 12. Retina Department, Institute of Ophthalmology, Fundación Conde de Valenciana, Mexico City, Mexico. 13. UPMC Eye Centre, University of Pittsburgh, Pittsburgh, PA, 15213, USA. jay.chhablani@gmail.com.
Abstract
OBJECTIVES: To analyse the longitudinal changes in visual acuity and risk factors for recurrence or development of choroidal neovascularisation (CNV) in eyes with acute or chronic central serous chorioretinopathy (CSCR). METHODS: This was a retrospective, multicentric, longitudinal, observational study done in patients with a diagnosis of unilateral or bilateral CSCR and having at least 4 years of follow-up between the years 1999 and 2020. Kaplan-Meier curves were used for assessing cumulative risks. Multivariate logistic, linear and cox regression models were used for risk factor analyses. The trend in visual acuity, cumulative risks of recurrence and CNV formation was analysed. RESULTS: A total of 117 out of 175 eyes (66.8%) had stable or improvement in vision at last follow-up, while 24 eyes had more than/equal to 3 line loss of vision. Four eyes (7.7%) with acute CSCR at initial presentation developed features of chronic CSCR at the final presentation. Thirty-seven eyes had recurrence during the follow-up with a 10-year cumulative recurrence rate of around 30%. On Cox proportional hazard regression analysis, history of previous treatment and male gender (p = 0.03) were associated with a lower risk of recurrence. Twenty-four developed de novo CNV by the end of follow-up and higher age (p = 0.001) and a higher number of recurrences (p = 0.05) were associated with a higher risk of early de novo CNV formation. The cumulative 10-year CNV development rate was 17.4%. CONCLUSION: A non-temporal relationship between acute and chronic CSCR was seen. Previous treatment, smoking and baseline RPE abnormality affected recurrence of SRF or CNV formation.
OBJECTIVES: To analyse the longitudinal changes in visual acuity and risk factors for recurrence or development of choroidal neovascularisation (CNV) in eyes with acute or chronic central serous chorioretinopathy (CSCR). METHODS: This was a retrospective, multicentric, longitudinal, observational study done in patients with a diagnosis of unilateral or bilateral CSCR and having at least 4 years of follow-up between the years 1999 and 2020. Kaplan-Meier curves were used for assessing cumulative risks. Multivariate logistic, linear and cox regression models were used for risk factor analyses. The trend in visual acuity, cumulative risks of recurrence and CNV formation was analysed. RESULTS: A total of 117 out of 175 eyes (66.8%) had stable or improvement in vision at last follow-up, while 24 eyes had more than/equal to 3 line loss of vision. Four eyes (7.7%) with acute CSCR at initial presentation developed features of chronic CSCR at the final presentation. Thirty-seven eyes had recurrence during the follow-up with a 10-year cumulative recurrence rate of around 30%. On Cox proportional hazard regression analysis, history of previous treatment and male gender (p = 0.03) were associated with a lower risk of recurrence. Twenty-four developed de novo CNV by the end of follow-up and higher age (p = 0.001) and a higher number of recurrences (p = 0.05) were associated with a higher risk of early de novo CNV formation. The cumulative 10-year CNV development rate was 17.4%. CONCLUSION: A non-temporal relationship between acute and chronic CSCR was seen. Previous treatment, smoking and baseline RPE abnormality affected recurrence of SRF or CNV formation.