Optical coherence tomography characteristics and their relationship with vision prognosis in central serous chorioretinopathy patients with different symptom duration before and after photodynamic therapy_Chinese Journal of Ocular Fundus Diseases

Authors：

LiangYanhua ,  SongYanping , DingQin , 陈中山

Wuhan Clinical Medical School of Southern Medical University, Wuhan 430070, China;

Corresponding author：

SongYanping, Email: songyanping@medmail.com.cn

Keywords：

Central serous chorioretinopathy/therapy; Tomography, optical coherence

DOI：

10.3760/cma.j.issn.1005-1015.2015.05.004

Video：

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Objective To observe the characteristics of optical coherence tomography (OCT) in central serous chorioretinopathy (CSC) patients with different symptom duration before and after photodynamic therapy (PDT), and investigate its relationship with vision prognosis. Methods 93 CSC patients (103 eyes) who had undergone the treatment of PDT were enrolled in this study. The eyes were divided into 3 groups according to symptom duration including group A (< 4 months, 28 eyes), group B (4-6 months, 42 eyes), group C (> 6 months, 33 eyes). The best corrected visual acuity (BCVA) and OCT were performed before and after treatment. Before the treatment, the percentage of patients with regular retinal pigment epithelium (RPE), irregular bump or detachment of RPE and disordered RPE were 63.0%, 37.0%, 0.0% in group A; 41.9%, 53.5%, 4.7% in group B and 24.2%, 57.6%, 18.2% in group C, respectively. The difference of percentage of RPE structure was no significance among the three groups (χ²=19.88, P=0.001). The outer nuclear layer (ONL) thickness was (220.42±49.88), (145.81±19.65), (98.15±33.02) μm in group A, B, C respectively, the difference between three groups was significant (P=0.000). The BCVA differences in different RPE structure and the relationship between ONL thickness and vision prognosis were recorded and analyzed. Results The difference of ONL thickness in eyes with regular RPE and irregular bump or detachment of RPE in group A, B and C were not significant (P=0.599, 0.151, 0.789). The ONL thickness in eyes with disordered RPE were decreased significantly compared to eyes with irregular bump or detachment of RPE in group B and C (P=0.025, 0.036). The ONL thickness were (139.14±26.23), (119.14±21.09), (97.61±29.92) μm after PDT, respectively. Compared with ONL thickness before PDT, there was statistically significant decreasing after PDT in group A and B (P=0.000, 0.010), but there was no statistically significant difference after PDT in group C (P=0.192). After PDT, BCVA was negatively related to ONL thickness before PDT in group A (r=-0.684, P=0.000), and was positively related to ONL thickness after PDT in group C (r=0.413, P=0.017), but was neither related to ONL thickness before nor after PDT in group C (r=0.278, 0.117; P=0.074, 0.462). Conclusions With the duration of symptom being longer, the rate of irregular bump or detachment of RPE and disordered RPE are increased gradually, ONL thickness is getting thinner. After PDT, the ONL thickness became thinner in eyes with symptom duration less than 6 months and has no difference in eyes with symptom duration more than 6 months. The difference of BCVA in eyes with different RPE structure is significant. The vision prognosis of CSC with duration less than 4 months or more than 6 months are related to ONL thickness.

Citation： LiangYanhua, SongYanping, DingQin. Optical coherence tomography characteristics and their relationship with vision prognosis in central serous chorioretinopathy patients with different symptom duration before and after photodynamic therapy. Chinese Journal of Ocular Fundus Diseases, 2015, 31(5): 425-429. doi: 10.3760/cma.j.issn.1005-1015.2015.05.004 Copy

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2.	Erikitola OC, Crosby-Nwaobi R, Lotery AJ, et al. Photodynamic therapy for central serous chorioretinopathy[J]. Eye (Lond), 2014, 28(8): 944-957.
3.	Wang MS, Sander B, Larsen M. Retinal atrophy in idiopathic central serous chorioretinopathy[J]. Am J Ophthalmol, 2002, 133(6): 787-793.
4.	Matsumoto H, Sato T, Kishi S. Outer nuclear layer thickness at the fovea determines visual outcomes in resolved central serous chorioretinopathy[J]. Am J Ophthalmol, 2009, 148(1): 105-110.
5.	闫峰, 孟凯, 门保成, 等.中心性浆液性脉络膜视网膜病变的频域光相干断层扫描观察[J].国际眼科杂志, 2013, 13(6):1189-1191.
6.	Hasegawa T, Okamoto M, Masuda N, et al. Relationship between foveal microstructures and visual outcomes in eyes with resolved central serous chorioretinopathy[J]. Graefe's Arch Clin Exp Ophthalmol, 2015, 253(3): 343-350.
7.	龚琦. SD-OCT观察CSCR形态学改变与视力的关系[J].国际眼科杂志, 2015, 15(2):298-300.
8.	Daruich A, Matet A, Dirani A, et al. Central serous chorioretinopathy: recent findings and new physiopathology hypothesis[J]. Prog Retin Eye Res, 2015, 48:82-118.
9.	Ahn SJ, Kim TW, Huh JW, et al. Comparison of features on SD-OCT between acute central serous chorioretinopathy and exudative age-related macular degeneration[J]. Ophthalmic Surg Lasers Imaging, 2012, 43(5): 374-382.
10.	Kim YY, Flaxel CJ. Factors influencing the visual acuity of chronic central serous chorioretinopathy[J]. Korean J Ophthalmol, 2011, 25(2):90-97.
11.	汤代文, 荣瑜, 王刘英, 等.中心性浆液性脉络膜视网膜病变荧光素眼底血管造影检查及预后分析[J].临床眼科杂志, 2008(5): 429-431.
12.	Furuta M, Iida T, Kishi S. Foveal thickness can predict visual outcome in patients with persistent central serous chorioretinopathy[J]. Ophthalmologica, 2009, 223(1): 28-31.
13.	Chen SN, Hwang JF, Tseng LF, et al. Subthreshold diode micropulse photocoagulation for the treatment of chronic central serous chorioretinopathy with juxtafoveal leakage[J]. Ophthalmology, 2008, 115(12): 2229-2234.
14.	Hua R, Liu L, Chen L. The noninvasive predictive approach for choroidal vascular diffuse hyperpermeability in central serous chorioretinopathy: near-infrared reflectance and enhanced depth imaging[J]. Photodiagnosis Photodyn Ther, 2014, 11(3): 365-371.
15.	Koizumi H, Yamagishi T, Yamazaki T, et al. Relationship between clinical characteristics of polypoidal choroidal vasculopathy and choroidal vascular hyperpermeability[J]. Am J Ophthalmol, 2013, 155(2): 305-313.
16.	Tseng CC, Chen SN. Long-term efficacy of half-dose photodynamic therapy on chronic central serous chorioretinopathy[J]. Br J Ophthalmol, 2015, 99(8):1070-1077.
17.	Wang MS, Sander B, Larsen M. Retinal atrophy in idiopathic central serous chorioretinopathy[J]. Am J Ophthalmol, 2002, 133(6): 787-793.

1. Wang M, Munch IC, Hasler PW, et al. Central serous chorioretinopathy[J]. Acta Ophthalmol, 2008, 86(2): 126-145.
2. Erikitola OC, Crosby-Nwaobi R, Lotery AJ, et al. Photodynamic therapy for central serous chorioretinopathy[J]. Eye (Lond), 2014, 28(8): 944-957.
3. Wang MS, Sander B, Larsen M. Retinal atrophy in idiopathic central serous chorioretinopathy[J]. Am J Ophthalmol, 2002, 133(6): 787-793.
4. Matsumoto H, Sato T, Kishi S. Outer nuclear layer thickness at the fovea determines visual outcomes in resolved central serous chorioretinopathy[J]. Am J Ophthalmol, 2009, 148(1): 105-110.
5. 闫峰, 孟凯, 门保成, 等.中心性浆液性脉络膜视网膜病变的频域光相干断层扫描观察[J].国际眼科杂志, 2013, 13(6):1189-1191.
6. Hasegawa T, Okamoto M, Masuda N, et al. Relationship between foveal microstructures and visual outcomes in eyes with resolved central serous chorioretinopathy[J]. Graefe's Arch Clin Exp Ophthalmol, 2015, 253(3): 343-350.
7. 龚琦. SD-OCT观察CSCR形态学改变与视力的关系[J].国际眼科杂志, 2015, 15(2):298-300.
8. Daruich A, Matet A, Dirani A, et al. Central serous chorioretinopathy: recent findings and new physiopathology hypothesis[J]. Prog Retin Eye Res, 2015, 48:82-118.
9. Ahn SJ, Kim TW, Huh JW, et al. Comparison of features on SD-OCT between acute central serous chorioretinopathy and exudative age-related macular degeneration[J]. Ophthalmic Surg Lasers Imaging, 2012, 43(5): 374-382.
10. Kim YY, Flaxel CJ. Factors influencing the visual acuity of chronic central serous chorioretinopathy[J]. Korean J Ophthalmol, 2011, 25(2):90-97.
11. 汤代文, 荣瑜, 王刘英, 等.中心性浆液性脉络膜视网膜病变荧光素眼底血管造影检查及预后分析[J].临床眼科杂志, 2008(5): 429-431.
12. Furuta M, Iida T, Kishi S. Foveal thickness can predict visual outcome in patients with persistent central serous chorioretinopathy[J]. Ophthalmologica, 2009, 223(1): 28-31.
13. Chen SN, Hwang JF, Tseng LF, et al. Subthreshold diode micropulse photocoagulation for the treatment of chronic central serous chorioretinopathy with juxtafoveal leakage[J]. Ophthalmology, 2008, 115(12): 2229-2234.
14. Hua R, Liu L, Chen L. The noninvasive predictive approach for choroidal vascular diffuse hyperpermeability in central serous chorioretinopathy: near-infrared reflectance and enhanced depth imaging[J]. Photodiagnosis Photodyn Ther, 2014, 11(3): 365-371.
15. Koizumi H, Yamagishi T, Yamazaki T, et al. Relationship between clinical characteristics of polypoidal choroidal vasculopathy and choroidal vascular hyperpermeability[J]. Am J Ophthalmol, 2013, 155(2): 305-313.
16. Tseng CC, Chen SN. Long-term efficacy of half-dose photodynamic therapy on chronic central serous chorioretinopathy[J]. Br J Ophthalmol, 2015, 99(8):1070-1077.
17. Wang MS, Sander B, Larsen M. Retinal atrophy in idiopathic central serous chorioretinopathy[J]. Am J Ophthalmol, 2002, 133(6): 787-793.

Chinese Journal of Ocular Fundus Diseases

Optical coherence tomography characteristics and their relationship with vision prognosis in central serous chorioretinopathy patients with different symptom duration before and after photodynamic therapy

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