Zhou Xiaoyin, Komuku Yuki, Araki Takashi, Hozumi Kenta, Terasaki Hiroto, Miki Akiko, Kuwayama Soichiro, Niki Masanori, Matsubara Hisashi, Kinoshita Takamasa, Nishi Tomo, Gomi Fumi
Department of Ophthalmology, Hyogo College of Medicine, Hyogo, Japan.
Japan Clinical Retina Study (JCREST) group, Kagoshima, Japan.
Acta Ophthalmol. 2022 Dec;100(8):e1729-e1736. doi: 10.1111/aos.15194. Epub 2022 May 28.
To investigate potential clinical and multimodal imaging factors in central serous chorioretinopathy (CSC) recurrence.
The study was performed at nine Japanese medical institutions for patients who had experienced an active CSC episode. Demographic data and medical history were reviewed retrospectively. Significant differences in chronic manifestation, leakage site, leakage point number, leakage intensity, choroidal hyperpermeability, central retinal thickness (CRT) and subfoveal choroidal thickness were analysed between the recurrence and non-recurrence groups.
In total, 538 eyes (538 patients) diagnosed with CSC (402 men, 136 women; mean age: 53.4 ± 11.9 years) were enrolled. Among them, 253 eyes (47.0%) developed ≥1 recurrence (follow-up: 15.9 ± 13.5 months, range 3-86 months). Univariate and multivariate analyses indicated that a history of corticosteroid use (odds ratio [OR], 5.52; 95% confidence interval [CI], 1.39-21.92; p = 0.015), bilateral disease (OR, 3.94; 95% CI, 1.47-10.6; p = 0.007), chronic manifestations (OR, 7.12; 95% CI, 2.93-17.28; p < 0.001), non-intense fluorescein leakage (OR, 3.34; 95% CI, 1.44-7.75; p = 0.005) and initial CRT (OR, 0.997; 95% CI, 0.993-0.999; p = 0.049) were significantly associated with CSC recurrence. Receiver operating characteristic curves were created, and the area under the curve for the multivariate logistic regression model of these five factors was 0.814.
Patients with CSC who received corticosteroids and had bilateral disease, chronic manifestation, non-intense fluorescein leakage on fluorescein angiography or a relatively thinner CRT should be closely monitored to identify whether they are at high risk of recurrence.
探讨中心性浆液性脉络膜视网膜病变（CSC）复发的潜在临床及多模态影像学因素。
该研究在日本9家医疗机构对曾经历过CSC活动期发作的患者进行。回顾性分析人口统计学数据和病史。分析复发组和未复发组在慢性表现、渗漏部位、渗漏点数、渗漏强度、脉络膜高通透性、中心视网膜厚度（CRT）及黄斑下脉络膜厚度方面的显著差异。
共纳入538例诊断为CSC的患者（538只眼）（男性402例，女性136例；平均年龄：53.4±11.9岁）。其中，253只眼（47.0%）出现≥1次复发（随访时间：15.9±13.5个月，范围3 - 86个月）。单因素和多因素分析表明，使用皮质类固醇激素史（比值比[OR]，5.52；95%置信区间[CI]，1.39 - 21.92；p = 0.015）、双侧患病（OR，3.94；95% CI，1.47 - 10.6；p = 0.007）、慢性表现（OR，7.12；95% CI，2.93 - 17.28；p < 0.001）、非强荧光素渗漏（OR，3.34；95% CI，1.44 - 7.75；p = 0.005）及初始CRT（OR，0.997；95% CI，0.993 - 0.999；p = 0.049）与CSC复发显著相关。绘制了受试者工作特征曲线，这五个因素的多变量逻辑回归模型的曲线下面积为0.814。
接受过皮质类固醇激素治疗、患有双侧疾病、有慢性表现、荧光素血管造影显示非强荧光素渗漏或CRT相对较薄的CSC患者应密切监测，以确定其是否处于高复发风险。
