Evaluation of Predictive Factors Associated with Resolution of Acute Central Serous Chorioretinopathy

Abstract

Background: Central serous Chorioretinopathy (CSC) is characterized by serous subretinal fluid (SRF)leakage and accumulation with subsequent serous retinal detachment We conducted this study to study the predictive factors associated with resolution of the non-treated, first episode of acute CSC including systemic factors and ocular factors using different imaging modalities. Methods: This prospective, observational study of 30 affected eyes and 30 fellow eyes of 30 consecutive patients with non-treated, first episode of acute CSC and age and sex matched control group of 30 eyes were also studied. Detailed history taking including: name, age, residence, previous and present ocular or systemic diseases, previous ocular trauma, previous ocular surgery, assessment of systemic factors including, smoking, hypertension, Helicobacter pylori infection, pregnancy, sleeping disturbance, autoimmune diseases and psychological factors, history of intake of ocular or systemic medications especially corticosteroid and psychopharmacological medications, best corrected visual acuity (BCVA). Results: The baseline BCVA of the "Improvement" group was lower than that of "No Improvement" group and the difference was statistically significant (p. value 0.014*). On the other hand, the final BCVA of the "Improvement" group was higher than that of "No Improvement" group and the difference was also statistically significant (p. value 0.005*). There was a statistically significant decrease of the mean automated central retinal thickness (ACRT) (P-value 0.004*), mean vertical SRF dimension (VD) (P-value 0.012*), mean horizontal SRF dimension (HD) (P-value 0.022*) and mean SRF height (P-value 0.002*). There was a statistically significant negative correlation between age (years) and the mean baseline SFCT (um) in both affected and fellow eyes (P-value 0.013* and 0.014* respectively). In other words, the older the patient was, the thinner the baseline SFCT in both eyes (affected and fellow) will be measured. Conclusions: Proper assessment of systemic factors associated with CSC and ocular factors using multimodal ocular imaging help us in predicting the course and visual prognosis of CSC cases. We depended on evaluating the difference of all variables between the "improvement group, n=22 cases" (decreased SRF height after 3 months) and "no improvement group, n=8 cases" (persistent/increased SRF height after 3 months).