TY - JOUR
T1 - Long-term Visual Outcomes and Causes of Vision Loss in Chronic Central Serous Chorioretinopathy
AU - Mrejen, Sarah
AU - Balaratnasingam, Chandrakumar
AU - Kaden, Talia R.
AU - Bottini, Alexander
AU - Dansingani, Kunal
AU - Bhavsar, Kavita V.
AU - Yannuzzi, Nicolas A.
AU - Patel, Samir
AU - Chen, Kevin C.
AU - Yu, Suqin
AU - Stoffels, Guillaume
AU - Spaide, Richard F.
AU - Freund, K. Bailey
AU - Yannuzzi, Lawrence A.
N1 - Funding Information:
Financial Disclosure(s): The author(s) have made the following disclosure(s): S.M.: Consultant – Novartis, Bayer. Financial Support: LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital (New York, NY), and The Macula Foundation, Inc (New York, NY). The funding organizations had no role in the design or conduct of this research. Obtained funding: Yannuzzi
Publisher Copyright:
© 2019 American Academy of Ophthalmology
PY - 2019/4
Y1 - 2019/4
N2 - Purpose: To evaluate the long-term visual outcomes and causes of vision loss in chronic central serous chorioretinopathy (CSC). Design: Retrospective, longitudinal study. Participants: A total of 133 participants (217 eyes) with chronic CSC. Methods: A retrospective review of clinical and multimodal imaging data of patients with chronic CSC managed by 3 of the authors between May 1977 and March 2018. Multimodal imaging comprised color photography, fluorescein angiography, indocyanine green angiography, fundus autofluorescence (FAF), and OCT. Main Outcome Measures: Best-corrected visual acuity (BCVA) at the final visit; change in BCVA between first visit and 1-, 5-, and 10-year follow-up visits; and causes of vision loss at final visit. Results: Data from 6228 individual clinic visits were analyzed. Mean age of patients at the first visit was 60.7 years, and mean period of follow-up from first to last visit was 11.3 years. The cohort included 101 male patients (75.9%). At the final visit, 106 patients (79.7%) maintained driving-standard vision with BCVA of 20/40 or better in at least 1 eye, and 17 patients (12.8%) were legally blind with BCVA of 20/200 or worse in both eyes. Mean BCVA at first visit was not significantly different from mean BCVA at 1- or 5-year follow-up visits (both P ≥ 0.65) but was significantly better than the mean BCVA at the 10-year follow-up visit (P = 0.04). Seventy-nine percent of eyes with 20/40 or better vision at the first visit maintained the same level of vision at the 10-year follow-up visit. Ninety-two percent of eyes with 20/200 or worse vision at the first visit maintained the same level of vision at the 10-year follow-up visit. Cystoid macular degeneration, choroidal neovascularization (CNV), outer retinal disruption on OCT, and FAF changes were associated with poorer vision at the final visit (all P ≤ 0.001). Multivariable analysis revealed that greater age at first visit was associated with greater BCVA change at the 10-year follow-up visit (P = 0.001). Conclusions: Chronic CSC can be a sight-threatening disease leading to legal blindness. Age at presentation and outer retinal changes on multimodal imaging were associated with long-term BCVA changes and may be predictors of long-term visual outcomes.
AB - Purpose: To evaluate the long-term visual outcomes and causes of vision loss in chronic central serous chorioretinopathy (CSC). Design: Retrospective, longitudinal study. Participants: A total of 133 participants (217 eyes) with chronic CSC. Methods: A retrospective review of clinical and multimodal imaging data of patients with chronic CSC managed by 3 of the authors between May 1977 and March 2018. Multimodal imaging comprised color photography, fluorescein angiography, indocyanine green angiography, fundus autofluorescence (FAF), and OCT. Main Outcome Measures: Best-corrected visual acuity (BCVA) at the final visit; change in BCVA between first visit and 1-, 5-, and 10-year follow-up visits; and causes of vision loss at final visit. Results: Data from 6228 individual clinic visits were analyzed. Mean age of patients at the first visit was 60.7 years, and mean period of follow-up from first to last visit was 11.3 years. The cohort included 101 male patients (75.9%). At the final visit, 106 patients (79.7%) maintained driving-standard vision with BCVA of 20/40 or better in at least 1 eye, and 17 patients (12.8%) were legally blind with BCVA of 20/200 or worse in both eyes. Mean BCVA at first visit was not significantly different from mean BCVA at 1- or 5-year follow-up visits (both P ≥ 0.65) but was significantly better than the mean BCVA at the 10-year follow-up visit (P = 0.04). Seventy-nine percent of eyes with 20/40 or better vision at the first visit maintained the same level of vision at the 10-year follow-up visit. Ninety-two percent of eyes with 20/200 or worse vision at the first visit maintained the same level of vision at the 10-year follow-up visit. Cystoid macular degeneration, choroidal neovascularization (CNV), outer retinal disruption on OCT, and FAF changes were associated with poorer vision at the final visit (all P ≤ 0.001). Multivariable analysis revealed that greater age at first visit was associated with greater BCVA change at the 10-year follow-up visit (P = 0.001). Conclusions: Chronic CSC can be a sight-threatening disease leading to legal blindness. Age at presentation and outer retinal changes on multimodal imaging were associated with long-term BCVA changes and may be predictors of long-term visual outcomes.
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U2 - 10.1016/j.ophtha.2018.12.048
DO - 10.1016/j.ophtha.2018.12.048
M3 - Article
C2 - 30659849
AN - SCOPUS:85061593506
SN - 0161-6420
VL - 126
SP - 576
EP - 588
JO - Ophthalmology
JF - Ophthalmology
IS - 4
ER -