Institute of Vision Research, Department of Ophthalmology, Severance Eye Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2024 Aug;38(4):304-315. doi: 10.3341/kjo.2024.0020. Epub 2024 Jul 16.
This study aimed to determine the incidence and visual outcomes of pachychoroid neovasculopathy (PNV) in patients initially diagnosed with central serous chorioretinopathy (CSC).
In this study, 144 patients aged 20 to 55 years with treatment-naive chronic CSC, defined as the persistence of subretinal fluid (SRF) for ≥6 months, were retrospectively enrolled. Patients with PNV at the initial evaluation were categorized as group 1, whereas those who developed new-onset PNV during follow-up were categorized as group 2. Patients without PNV until the end of the follow-up were categorized as group 3.
Over a mean follow-up period of 49.9 ± 39.9 months, new-onset PNV was diagnosed in 11.8% of patients with CSC. The time taken to reach the initial resolution was longest in group 1 (group 1, 11.13 ± 10.70 months; group 2, 8.14 ± 7.90 months; group 3, 7.32 ± 9.55 months), although these differences were not statistically significant. The numbers of injections needed to achieve initial resolution were 3.76 ± 5.90, 1.64 ± 2.06, and 1.74 ± 4.33 in groups 1, 2, and 3, respectively, with no significant differences. SRF recurrence was recorded in seven patients (29.2%) in group 1, nine (64.3%) in group 2, and 28 (26.7%) in group 3. The recurrence rates were significantly higher in group 2 than those in group 1 or 3. At the end of the follow-up period, significant improvements in best-corrected visual acuity were achieved in groups 1 and 3, compared with baseline, but not in group 2.
Patients with chronic CSC with new-onset PNV exhibited higher SRF recurrence and worse visual outcomes compared to those with initial PNV or those with chronic CSC without PNV. Our study emphasizes the importance of routine screening for prompt diagnoses of new-onset PNV in individuals with chronic CSC.
本研究旨在确定最初诊断为中心性浆液性脉络膜视网膜病变（CSC）的患者中，厚脉络膜新生血管（PNV）的发病情况和视力结果。
本研究回顾性纳入了 144 名年龄在 20 至 55 岁之间、未经治疗的慢性 CSC 患者，这些患者的定义为眼内液（SRF）持续存在至少 6 个月。在初次评估时患有 PNV 的患者被归类为第 1 组，而在随访期间发生新发性 PNV 的患者被归类为第 2 组。在随访结束时仍未发生 PNV 的患者被归类为第 3 组。
在平均 49.9 ± 39.9 个月的随访期间，11.8%的 CSC 患者被诊断出新发 PNV。第 1 组达到初始缓解的时间最长（第 1 组：11.13 ± 10.70 个月；第 2 组：8.14 ± 7.90 个月；第 3 组：7.32 ± 9.55 个月），尽管这些差异无统计学意义。第 1、2 和 3 组分别需要 3.76 ± 5.90、1.64 ± 2.06 和 1.74 ± 4.33 次注射才能达到初始缓解，差异无统计学意义。第 1 组有 7 名患者（29.2%）出现 SRF 复发，第 2 组有 9 名患者（64.3%）出现 SRF 复发，第 3 组有 28 名患者（26.7%）出现 SRF 复发，第 2 组的复发率明显高于第 1 组或第 3 组。在随访结束时，与基线相比，第 1 组和第 3 组的最佳矫正视力均有显著改善，但第 2 组没有。
与最初患有 PNV 或患有慢性 CSC 但无 PNV 的患者相比，新发 PNV 的慢性 CSC 患者的 SRF 复发率更高，视力结果更差。我们的研究强调了在慢性 CSC 患者中进行常规筛查以及时诊断新发 PNV 的重要性。
