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      Risk Factors for Recurrence of Serous Macular Detachment in Untreated Patients with Central Serous Chorioretinopathy

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          Abstract

          Background: To evaluate risk factors for the recurrence of serous macular detachment in untreated patients with central serous chorioretinopathy (CSC). Methods: Retrospective review of untreated CSC patients with a follow-up of ≧3 years. Patient demographics, visual outcome and risk factors for the recurrence of CSC were analyzed. Results: Seventy-three eyes of 73 patients were included, and the mean age was 44.6 years. At baseline, the mean logMAR best corrected visual acuity (BCVA) was 0.30. After a mean follow-up of 72 months, the mean final logMAR BCVA was 0.32. The difference between the final and baseline BCVAs was not statistically significant (p = 0.79). At the last follow-up, 9 (12.3%) eyes showed improved vision of ≧2 lines, and 12 (16.4%) showed a worsening of ≧2 lines. During follow-up, 38 (52.1%) patients experienced ≧1 episode of CSC recurrence. Multivariate Cox regression analysis showed that patients with a history of psychiatric illness (adjustment disorder and depression) were associated with an increased risk of CSC recurrence (hazard ratio = 3.5, p = 0.011). Conclusions: The long-term visual prognosis of CSC is fair without treatment, and a significant proportion of patients developed recurrence of CSC. A history of psychiatric illness is associated with an increased risk of CSC recurrence.

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          Risk factors for central serous chorioretinopathy: a case-control study.

          David R. Gagnon, Sarah Wellik, … (2004)
          To identify systemic factors associated with the development of central serous chorioretinopathy (CSCR). Retrospective, case-control study. 312 cases and 312 controls. By use of a multivariate analysis, the previously described risk factors, systemic steroid use (odds ratio [OR], 37.1; 95% confidence interval [CI], 6.2-221.8), and pregnancy (OR, 7.1; 95% CI, 1.0-50.7), were strongly associated with CSCR. Additional risk factors identified by this study include antibiotic use (OR, 6.2; 95% CI, 1.0-37.9), alcohol use (OR, 4.9; 95% CI, 1.5-16.3), untreated hypertension (OR, 3.3; 95% CI, 1.3-8.5), and allergic respiratory disease (OR, 2.5; 95% CI, 1.2-5.1). A wide variety of systemic factors are associated with CSCR. Prospective studies are warranted to evaluate the nature and significance of these associations further.
          Article 0 comments Cited 114 times – based on 0 reviews     Review now
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            Half-dose verteporfin photodynamic therapy for acute central serous chorioretinopathy: one-year results of a randomized controlled trial.

            Agnes Y K Lai, David Liu, Sze Wai Chan … (2008)
            To evaluate the efficacy of photodynamic therapy (PDT) with half-dose verteporfin for treating acute central serous chorioretinopathy (CSC). Prospective, double-masked, placebo-controlled, randomized clinical trial. Sixty-three eyes of 63 patients with acute symptomatic CSC of 3 months' duration or less were recruited. Forty-three eyes were randomized to indocyanine green angiography (ICGA)-guided PDT with half-dose (3 mg/m(2)) verteporfin and 21 eyes were randomized to placebo. Patients in the verteporfin group received an infusion of half-dose verteporfin over 8 minutes, followed by ICGA-guided PDT 10 minutes from the start of infusion. Laser was applied for 83 seconds covering the choroidal abnormalities observed in ICGA, with a maximum laser spot size of 4500 mum. The primary outcome measure was the proportion of eyes with absence of subretinal fluid at the macula at 12 months. Secondary outcome measures included changes in mean logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA), subjective symptoms, optical coherence tomography (OCT) results, central foveal thickness (CFT), and angiographic findings during the 12-month study period. Thirty-nine patients in the verteporfin group and 19 patients in the placebo group completed 12 months of follow-up. Thirty-seven (94.9%) eyes in the verteporfin group compared with 11 (57.9%) eyes in the placebo group showed absence of subretinal fluid at the macula at 12 months (P = 0.001). The mean logMAR BCVA at 12 months was significantly better in the verteporfin group compared with the placebo group: -0.05 and 0.05, respectively (P = 0.008). All 39 (100%) verteporfin-treated eyes had stable or improved vision, compared with 15 (78.9%) eyes in the placebo group (P = 0.009). The mean OCT CFT for the verteporfin group also was significantly lower compared with the placebo group at 12 months (P = 0.001). No ocular or systemic adverse event was encountered in the study. Photodynamic therapy with half-dose verteporfin is effective in treating acute symptomatic CSC, resulting in a higher proportion of patients with absence of exudative macular detachment and better visual acuity compared with placebo.
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              Safety enhanced photodynamic therapy for chronic central serous chorioretinopathy: one-year results of a prospective study.

              L. Liu, Sze Wai Chan, Dennis Lam … (2007)
              To evaluate the efficacy of a safety enhanced photodynamic therapy (PDT) protocol with half-dose verteporfin for treating chronic central serous chorioretinopathy (CSC). Forty-eight eyes of 48 patients with symptomatic chronic CSC underwent indocyanine green angiography guided PDT with half dose (3 mg/m) verteporfin. Outcome measures included logMAR best-corrected visual acuity (BCVA), central retinal thickness, and angiographic changes during the 12-month study period. The mean CSC duration was 8.2 months (range, 3-40 months). At 12 months after PDT, the mean logMAR BCVA improved from 0.31 to 0.15 (P < 0.001). The mean improvement was 1.6 lines and 45 (95.8%) eyes had stable or improved vision. Eyes without pigment epithelial detachment (PED) had significantly greater visual improvement compared with eyes with PED (P = 0.031). Patients with CSC of 6 months or less or younger than 45 years were more likely to gain vision by two or more lines after treatment (P = 0.007 and P = 0.018, respectively). Forty (83.3%) eyes had complete resolution of serous detachment at 3 months, with 43 (89.6%) eyes at 12 months. The safety enhanced PDT protocol appeared to be beneficial for patients with chronic CSC. Further controlled study is warranted to evaluate the safety and efficacy of this treatment option.
              Article 0 comments Cited 52 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (publisher-id): ORE
                Journal ID (nlm-ta): Ophthalmic Res
                Journal ID (doi): 10.1159/issn.0030-3747
                Title: Ophthalmic Research
                Publisher: S. Karger AG
                ISSN (Print): 0030-3747
                ISSN (Electronic): 1423-0259
                Publication date Subscription-year: 2011
                Publication date (Print): September 2011
                Publication date (Electronic): 10 March 2011
                Volume: 46
                Issue: 3
                Pages: 160-163
                Affiliations
                Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong, PR China
                Author notes
                *Timothy Y.Y. Lai, MD, FRCS, Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, 3/F Hong Kong Eye Hospital, 147K Argyle Street, Kowloon, Hong Kong (PR China), Tel. +852 2762 3153, E-Mail tyylai@cuhk.edu.hk
                Article
                Publisher ID: 324599 Other ID: Ophthalmic Res 2011;46:160–163
                DOI: 10.1159/000324599
                PubMed ID: 21389741
                SO-VID: 38e3abec-b4bc-4b86-9772-e15b115ec884
                Copyright © © 2011 S. Karger AG, Basel
                License:

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Date received : 11 August 2010
                Date accepted : 20 January 2011
                Page count
                Figures: 1, Tables: 2, Pages: 4
                Categories
                Subject: Short Communication

                ScienceOpen disciplines: Vision sciences,Ophthalmology & Optometry,Pathology
                Keywords: Serous macular detachment,Central serous chorioretinopathy,Recurrence,Psychiatric illness
                Data availability:
                ScienceOpen disciplines: Vision sciences, Ophthalmology & Optometry, Pathology
                Keywords: Serous macular detachment, Central serous chorioretinopathy, Recurrence, Psychiatric illness

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