Son Ki Young, Lim Seul Gi, Hwang Sungsoon, Choi Jaehwan, Kim Sang Jin, Kang Se Woong
Department of Ophthalmology, Chungnam National University Sejong Hospital, Sejong, Korea (the Republic of).
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of).
Br J Ophthalmol. 2024 Dec 17;109(1):89-97. doi: 10.1136/bjo-2023-324147.
BACKGROUND/AIMS: This study aimed to investigate the clinical characteristics and treatment outcomes of patients with active central serous chorioretinopathy (CSC) and foveal atrophy.
Patients diagnosed with active idiopathic CSC using multimodal imaging and followed up for at least 6 months were included. They were divided into two groups (foveal atrophy group vs foveal non-atrophy group) according to a cut-off central foveal thickness of 120 µm on baseline optical coherence tomography (OCT). Baseline characteristics, angiographic and tomographic features and treatment outcomes were compared between the two groups.
Of the 463 patients, 92 eyes of 92 patients (19.9%) were in the foveal atrophy group and 371 eyes of 371 patients (80.1%) were in the foveal non-atrophy group. The baseline subretinal fluid (SRF) height was 111.3±76.8 µm in the foveal atrophy group and 205.0±104.4 µm in the foveal non-atrophy group on OCT images (p<0.001). Complete resolution of SRF after treatment was noted in 60.4% and 93.5% of patients in the foveal atrophy and foveal non-atrophy groups at the final visit, respectively (p<0.001). The foveal atrophy group showed worse visual acuity at baseline (logarithm of the minimum angle of resolution, 0.43±0.33 vs 0.13±0.18, p<0.001) and final visit (0.41±0.32 vs 0.05±0.15, p=0.035).
CSC with foveal atrophy was associated with a shallow SRF height, low treatment efficacy and poor vision before and after treatment. We suggest that early active treatment should be considered for eyes with CSC accompanied by a persistent shallow SRF and foveal atrophy.
背景/目的：本研究旨在调查活动性中心性浆液性脉络膜视网膜病变（CSC）合并黄斑萎缩患者的临床特征及治疗效果。
纳入经多模态成像诊断为活动性特发性CSC且随访至少6个月的患者。根据基线光学相干断层扫描（OCT）上中央黄斑厚度120 µm的临界值，将他们分为两组（黄斑萎缩组与黄斑非萎缩组）。比较两组的基线特征、血管造影和断层扫描特征以及治疗效果。
463例患者中，92例患者的92只眼（19.9%）属于黄斑萎缩组，371例患者的371只眼（80.1%）属于黄斑非萎缩组。OCT图像上，黄斑萎缩组基线视网膜下液（SRF）高度为111.3±76.8 µm，黄斑非萎缩组为205.0±104.4 µm（p<0.001）。末次随访时，黄斑萎缩组和黄斑非萎缩组分别有60.4%和93.5%的患者SRF完全消退（p<0.001）。黄斑萎缩组在基线时视力较差（最小分辨角对数，0.43±0.33对0.13±0.18，p<0.001），末次随访时同样较差（0.41±0.32对0.05±0.15，p=0.035）。
合并黄斑萎缩的CSC与SRF高度较浅、治疗效果低以及治疗前后视力差相关。我们建议，对于伴有持续性浅SRF和黄斑萎缩的CSC患眼应考虑早期积极治疗。
