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Kogo T, Muraoka Y, Ishikura M, Nishigori N, Akiyama Y, Ueda-Arakawa N, Miyata M, Ooto S, Hata M, Takahashi A, Miyake M, Tsujikawa A. Pigment Epithelial Detachment and Leak Point Locations in Central Serous Chorioretinopathy. Am J Ophthalmol 2024; 261:19-27. [PMID: 38244961 DOI: 10.1016/j.ajo.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/12/2024] [Accepted: 01/12/2024] [Indexed: 01/22/2024]
Abstract
PURPOSE To examine the associations between the vortex vein characteristics and locations of the pigment epithelial detachment (PED) and leak point in patients with central serous chorioretinopathy (CSC). DESIGN Observational case series. METHODS We evaluated 116 eyes of 104 patients with CSC. The PED and leak point locations were superimposed over the choroidal en face images using widefield swept-source optical coherence tomography and fluorescein angiography. We defined the draining areas of the superior and inferior vortex veins and analyzed their associations with the PED and leak point locations. RESULTS One of the 116 eyes with a unique irrigation pattern dominated by the nasal vortex vein was excluded from the analysis. Sixty-nine (60%) of the remaining 115 eyes exhibited asymmetry between the superior and inferior vortex veins. PEDs and leak points were in the vortex vein draining area with greater dilation in 66 (96%) of 69 eyes with asymmetry, and none (0%) were in the opposite areas. Both the PEDs and leak points showed significant differences in their distributions (P < .001, respectively). Additionally, 74% of PEDs and 84% of leak points were located upstream of the vortex vein draining areas, whose frequency was significantly higher compared to other areas (P < .001, respectively). CONCLUSION PED and leak point spatial distributions corresponded with the most terminal part of the dilated vortex veins, suggesting that blood flow disturbances, such as stasis within the affected vortex veins, may be essential in the pathogenesis of CSC.
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Affiliation(s)
- Takahiro Kogo
- From the Department of Ophthalmology and Visual Sciences (T.K., Y.M., M.I., N.N., Y.A., N.U.A., M.M., S.O., M.H., A.T., M.M., A.T.), Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yuki Muraoka
- From the Department of Ophthalmology and Visual Sciences (T.K., Y.M., M.I., N.N., Y.A., N.U.A., M.M., S.O., M.H., A.T., M.M., A.T.), Kyoto University Graduate School of Medicine, Kyoto, Japan.
| | - Masaharu Ishikura
- From the Department of Ophthalmology and Visual Sciences (T.K., Y.M., M.I., N.N., Y.A., N.U.A., M.M., S.O., M.H., A.T., M.M., A.T.), Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Naomi Nishigori
- From the Department of Ophthalmology and Visual Sciences (T.K., Y.M., M.I., N.N., Y.A., N.U.A., M.M., S.O., M.H., A.T., M.M., A.T.), Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yuki Akiyama
- From the Department of Ophthalmology and Visual Sciences (T.K., Y.M., M.I., N.N., Y.A., N.U.A., M.M., S.O., M.H., A.T., M.M., A.T.), Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Naoko Ueda-Arakawa
- From the Department of Ophthalmology and Visual Sciences (T.K., Y.M., M.I., N.N., Y.A., N.U.A., M.M., S.O., M.H., A.T., M.M., A.T.), Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Manabu Miyata
- From the Department of Ophthalmology and Visual Sciences (T.K., Y.M., M.I., N.N., Y.A., N.U.A., M.M., S.O., M.H., A.T., M.M., A.T.), Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Sotaro Ooto
- From the Department of Ophthalmology and Visual Sciences (T.K., Y.M., M.I., N.N., Y.A., N.U.A., M.M., S.O., M.H., A.T., M.M., A.T.), Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masayuki Hata
- From the Department of Ophthalmology and Visual Sciences (T.K., Y.M., M.I., N.N., Y.A., N.U.A., M.M., S.O., M.H., A.T., M.M., A.T.), Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ayako Takahashi
- From the Department of Ophthalmology and Visual Sciences (T.K., Y.M., M.I., N.N., Y.A., N.U.A., M.M., S.O., M.H., A.T., M.M., A.T.), Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masahiro Miyake
- From the Department of Ophthalmology and Visual Sciences (T.K., Y.M., M.I., N.N., Y.A., N.U.A., M.M., S.O., M.H., A.T., M.M., A.T.), Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akitaka Tsujikawa
- From the Department of Ophthalmology and Visual Sciences (T.K., Y.M., M.I., N.N., Y.A., N.U.A., M.M., S.O., M.H., A.T., M.M., A.T.), Kyoto University Graduate School of Medicine, Kyoto, Japan
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Paez-Escamilla M, Caplash S, Kalra G, Odden J, Price D, Marroquin OC, Koscumb S, Commiskey P, Indermill C, Finkelstein J, Gushchin AG, Coca A, Friberg TR, Eller AW, Gallagher DS, Harwick JC, Waxman EL, Chhablani J, Bonhomme G, Prensky C, Anetakis AJ, Martel JN, Massicotte E, Ores R, Girmens JF, Pearce TM, Sahel JA, Dansingani K, Westcott M, Errera MH. Challenges in posterior uveitis-tips and tricks for the retina specialist. J Ophthalmic Inflamm Infect 2023; 13:35. [PMID: 37589912 PMCID: PMC10435440 DOI: 10.1186/s12348-023-00342-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 04/07/2023] [Indexed: 08/18/2023] Open
Abstract
PURPOSE Posterior uveitis is a common chorioretinal pathology affecting all ages worldwide and is a frequent reason for referral to the retina clinic. The spectrum of etiologies for uveitis is very broad and includes infectious and auto-immune diseases. Inflammation can be confined to the eye or may be a part of systemic disease. A useful outline is therefore proposed to aid in the correct diagnosis of these challenging entities. The situation is further complicated by the fact that many neoplastic conditions resemble features of posterior uveitis; they are known as "masqueraders of uveitis". Here, we summarize different posterior uveitides that present with rare findings, along with masqueraders that can be difficult to distinguish. These conditions pose a diagnostic dilemma resulting in delay in treatment because of diagnostic uncertainty. METHODS An extensive literature search was performed on the MEDLINE/PUBMED, EBSCO and Cochrane CENTRAL databases from January 1985 to January 2022 for original studies and reviews of predetermined diagnoses that include posterior uveitic entities, panuveitis and masquerade syndromes. RESULTS We described conditions that can present as mimickers of posterior uveitis (i.e., immune check-points inhibitors and Vogt-Koyanagi-Harada-like uveitis; leukemia and lymphoma associated posterior uveitis), inflammatory conditions that present as mimickers of retinal diseases (i.e., Purtscher-like retinopathy as a presentation of systemic lupus erythematosus; central serous chorioretinopathy masquerading inflammatory exudative retinal detachment), and uveitic conditions with rare and diagnostically challenging etiologies (i.e., paradoxical inflammatory effects of anti-TNF-α; post vaccination uveitis; ocular inflammation after intravitreal injection of antiangiogenic drugs). CONCLUSION This review of unique posterior uveitis cases highlights the overlapping features of posterior uveitis (paradoxical inflammatory effects of anti -TNF α and uveitis; Purtscher-like retinopathy as a presentation of systemic lupus erythematosus, …) and the nature of retinal conditions (ischemic ocular syndrome, or central retinal vein occlusion, amyloidosis, inherited conditions like retinitis pigmentosa, autosomal dominant neovascular inflammatory vitreoretinopathy (ADNIV), etc.…) that may mimic them is represented. Careful review of past uveitis history, current medications and recent vaccinations, detailed examination of signs of past or present inflammation, eventually genetic testing and/ or multimodal retinal imaging (like fluorescein angiography, EDI-OCT, OCT-angiography for lupus Purtscher-like retinopathy evaluation, or ICG for central serous retinopathy, or retinal amyloid angiopathy) may aid in correct diagnosis.
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Affiliation(s)
- Manuel Paez-Escamilla
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Sonny Caplash
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Gagan Kalra
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jamie Odden
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Danielle Price
- Clinical Analytics, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Stephen Koscumb
- Clinical Analytics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Patrick Commiskey
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Chad Indermill
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jerome Finkelstein
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Anna G Gushchin
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Andreea Coca
- Department of Rheumatology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Thomas R Friberg
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Andrew W Eller
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Denise S Gallagher
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jean C Harwick
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Evan L Waxman
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jay Chhablani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Gabrielle Bonhomme
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Colin Prensky
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Alexander J Anetakis
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Joseph N Martel
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Erika Massicotte
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Raphaelle Ores
- Department of Ophthalmology, McGill University Campus Outaouais, Gatineau, QC, Canada
| | | | - Thomas M Pearce
- Division of Neuropathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Jose-Alain Sahel
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kunal Dansingani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Mark Westcott
- Department of Uveitis, Moorfields Eye Hospital, NHS Foundation Trust, London, UK
| | - Marie-Helene Errera
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
- UPMC Eye Center, University of Pittsburgh School of Medicine, 203 Lothrop Street, Pittsburgh, PA, 15213, USA.
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Arora S, Rosario B, Mohammed AR, Beale O, Selvam A, Venkatesh R, Maltsev DS, Chhablani J. Regression patterns of central serous chorioretinopathy using en face optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 2022; 260:2475-2481. [PMID: 35357548 DOI: 10.1007/s00417-022-05636-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/01/2022] [Accepted: 03/19/2022] [Indexed: 01/13/2023] Open
Abstract
PURPOSE To study the regression patterns of subretinal fluid (SRF) in central serous chorioretinopathy (CSCR) on sequential en face optical coherence tomography (OCT) and its relationship to leak locations. METHODS Retrospective study on patients with acute CSCR. Inclusion criteria were (i) availability of data, sequential OCT and OCT angiography (B scan and en face OCT) every 2 weeks until resolution of SRF or 6 months, whichever is earlier; (ii) single active leak. Exclusion criteria were (i) presence of macular neovascularization or atypical CSCR, (ii) diffuse pigment epitheliopathy, (iii) multiple leaks. Serial en face OCT scans were evaluated and the area of SRF was measured using ImageJ software. Correlation coefficient was calculated for the regression rate of SRF area and central retinal thickness (CRT) over the first month of follow-up and the time of complete SRF resolution. RESULTS Out of the 25 eyes, 20 eyes demonstrated a centripetal regression, and 5 eyes demonstrated a centrifugal regression. In eyes with a leakage point <1000μ from the fovea, 86% resolved in a centripetal fashion, and in eyes with leak site ≥1000μ away from fovea, 70% eyes resolved centripetally. There was a correlation (r=-0.47, p=0.018) of the rate regression of SRF area during the first month and timing of resolution. In contrast, this correlation was absent (r=-0.16, p=0.44) for CRT regression. CONCLUSION Our en face-based analysis of sequential OCTs of regressing CSCR demonstrated a tendency for the subfoveal SRF to resolve towards the end or a centripetal pattern of regression. Prediction of resolution of SRF at 1 month is better with en face area of SRF in comparison to CRT.
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Affiliation(s)
- Supriya Arora
- Bahamas Vision Centre and Princess Margaret Hospital, Nassau NP, Bahamas
| | - Brian Rosario
- UPMC Eye Center, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Oliver Beale
- UPMC Eye Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Amrish Selvam
- UPMC Eye Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ramesh Venkatesh
- Department of Retina and Vitreous, Narayana Nethralaya, Bengaluru, India
| | - Dmitrii S Maltsev
- Department of Ophthalmology, Military Medical Academy, St. Petersburg, Russian Federation
| | - Jay Chhablani
- UPMC Eye Center, University of Pittsburgh, Pittsburgh, PA, USA.
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Norouzpour A. Light exposure in acute central serous chorioretinopathy. Eye (Lond) 2022; 36:243. [PMID: 33423042 PMCID: PMC8727572 DOI: 10.1038/s41433-020-01388-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 11/25/2020] [Accepted: 12/18/2020] [Indexed: 02/06/2023] Open
Affiliation(s)
- Amir Norouzpour
- grid.412571.40000 0000 8819 4698Poostchi Eye Clinic, Shiraz University of Medical Sciences, Shiraz, Iran
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Sahoo NK, Singh SR, Beale O, Nkrumah G, Rasheed MA, Jabeen A, Vupparaboina KK, Ibrahim MN, Tatti F, Chandra K, Lanza M, Iovino C, Peiretti E, Chhablani J. Choroidal Vascularity Map in Unilateral Central Serous Chorioretinopathy: A Comparison with Fellow and Healthy Eyes. Diagnostics (Basel) 2021; 11:diagnostics11050861. [PMID: 34064718 PMCID: PMC8150964 DOI: 10.3390/diagnostics11050861] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/07/2021] [Accepted: 05/08/2021] [Indexed: 11/23/2022] Open
Abstract
Background: To map the choroidal vascularity index and compare two eyes in patients with unilateral central serous chorioretinopathy (CSCR). Methods: This was a retrospective, observational study performed in patients with unilateral CSCR. Choroidal thickness (CT) and Choroidal vascularity index (CVI) were measured and mapped in various zones according to the early treatment diabetic retinopathy (ETDRS) grid. Results: A total of 20 CSCR patients (20 study and 20 fellow eyes) were included in the study. Outer nasal region CT was seen to be significantly lower than central CT (p = 0.042) and inner nasal CT (p = 0.007); outer ring CT was significantly less than central (p = 0.04) and inner ring (p = 0.01) CT in CSCR eyes. On potting all the CVI values against the corresponding CT values, a positive correlation was seen in CSCR eyes (r = 0.54, p < 0.01), which was slightly weaker in fellow eyes (r = 0.3, p < 0.01) and a negative correlation was seen in healthy eyes (r = −0.262, p < 0.01). Conclusions: Correlation between CVI and CT was altered in CSCR eyes as compared to fellow and normal eyes with increasing CVI towards the center of the macula and superiorly in CSCR eyes.
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Affiliation(s)
- Niroj Kumar Sahoo
- Department of Retina and Vitreous, L V Prasad Eye Institute, Vijayawada 521134, India;
| | - Sumit Randhir Singh
- Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, San Diego, CA 92697, USA;
| | - Oliver Beale
- UPMC Eye Centre, University of Pittsburgh, Pittsburgh, PA 15213, USA; (O.B.); (G.N.); (K.K.V.)
| | - Gideon Nkrumah
- UPMC Eye Centre, University of Pittsburgh, Pittsburgh, PA 15213, USA; (O.B.); (G.N.); (K.K.V.)
| | - Mohammed Abdul Rasheed
- School of Optometry and Vision Science, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (M.A.R.); (A.J.)
| | - Asiya Jabeen
- School of Optometry and Vision Science, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (M.A.R.); (A.J.)
| | | | - Mohammed Nasar Ibrahim
- Department of Electrical Engineering, Indian Institute of Technology, Hyderabad 502285, India;
| | - Filippo Tatti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 9121 Cagliari, Italy; (F.T.); (E.P.)
| | - Khushboo Chandra
- Department of Vitreoretina, Disha Eye Hospitals Pvt Ltd., 88(63A) Ghosh Para Road, Barrackpore, Kolkata 700120, India;
| | - Michele Lanza
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 81100 Naples, Italy; (M.L.); (C.I.)
| | - Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, 81100 Naples, Italy; (M.L.); (C.I.)
| | - Enrico Peiretti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 9121 Cagliari, Italy; (F.T.); (E.P.)
| | - Jay Chhablani
- UPMC Eye Centre, University of Pittsburgh, Pittsburgh, PA 15213, USA; (O.B.); (G.N.); (K.K.V.)
- Correspondence: ; Tel.: +1-412-377-1943
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Singh SR, Beale O, Nkrumah G, Rasheed MA, Sahoo NK, Vupparaboina KK, Tatti F, Chandra K, Iovino C, Peiretti E, Chhablani J. Correlation of sectoral choroidal vascularity with angiographic leakage in central serous chorioretinopathy. Eur J Ophthalmol 2021; 32:11206721211013653. [PMID: 33947248 DOI: 10.1177/11206721211013653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To correlate sectoral choroidal vascularity with angiographic leakage in eyes with central serous chorioretinopathy (CSCR). METHODS This was a retrospective, cross-sectional study including patients with active CSCR. Multimodal imaging including fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) were performed to identify leakage site and obtain choroidal measurements, respectively. An automated algorithm was used to perform shadow compensation, choroidal boundary localization and binarization, three (3-D) dimensional mapping, and early treatment of diabetic retinopathy study (ETDRS) grid based choroidal quantification that is, choroidal thickness (CT) and choroidal vascularity index (CVI). Nested analysis of variance (ANOVA) was performed to compare CT and CVI in different sectors. RESULTS Thirty-two eyes with active CSCR were analyzed. CT values varied significantly among the sectors (range, 450.27-482.63 µm; p = 0.005) and rings (range, 459.71-480.45 µm; p < 0.001), however, CVI failed to show significant variation among various segments (sectors, rings, and quadrants; range, 0.53-0.54; all p values > 0.05). Among 25 leaking spots in 25 different sectors, 12 (48%) had an increased CT compared to the overall CT whereas only 24% had increased CVI compared to overall CVI. Mean CT and CVI of the sectors with leakage (427.1 ± 81.1 µm; 0.51 ± 0.05) and remaining sectors without leakage (411.3 ± 73.9 µm; 0.53 ± 0.04) were not statistically different (p = 0.48; p = 0.12, respectively). CONCLUSION Though CT varied in different segments and increased CT corresponded to leakage points on FFA in 48% of eyes, CVI changes were more diffusely spread and local changes in CVI were not predictive of leakage location in eyes with active CSCR.
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Affiliation(s)
- Sumit Randhir Singh
- Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, San Diego, CA, USA
| | - Oliver Beale
- UPMC Eye Centre, University of Pittsburgh, Pittsburgh, PA, USA
| | - Gideon Nkrumah
- UPMC Eye Centre, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Niroj Kumar Sahoo
- L. V. Prasad Eye Institute, Tadigadapa, Vijayawada, Andhra Pradesh, India
| | | | - Filippo Tatti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Khushboo Chandra
- Dept. of Vitreoretina, Disha Eye Hospitals Pvt Ltd, Kolkata, India
| | - Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - Enrico Peiretti
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Jay Chhablani
- UPMC Eye Centre, University of Pittsburgh, Pittsburgh, PA, USA
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Axial length as a basic anatomical predictor for morphological and clinical characteristics in acute central serous chorioretinopathy. Eye (Lond) 2020; 34:2063-2067. [PMID: 31969681 DOI: 10.1038/s41433-020-0774-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/20/2019] [Accepted: 12/08/2019] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To study the association between axial length (AL) and morphological and clinical characteristics in acute central serous chorioretinopathy. METHODS All patients received optical coherence tomography, fluorescein angiography (FA), optical biometry, and retro-mode scanning laser ophthalmoscopy. The distance between the leakage point and the centre of the fovea were defined using FA images, and its correlation with AL, subfoveal choroidal thickness (SCT), central retinal thickness (CRT), and neurosensory detachment (NSD) area was calculated. The number of leaks, rate of bilateral involvement, and recurrence rate was evaluated. RESULTS Forty-seven patients (47 eyes) were included in this study (38 males, 9 females, mean age 43.5 ± 10.8 years). The distance between the leakage point and the centre of the fovea had a correlation with AL (r = -0.38, p = 0.008), SCT (r = 0.51, p = 0.0004), and the area of NSD (r = 0.5, p = 0.0006) but not with CRT (r = -0.11, p = 0.45). A statistically significant difference in the distance between the leakage point and the centre of the fovea was found between eyes with short (<23.0 mm), medium (23.0-24.0 mm), and long (>24.0 mm) AL (p = 0.014). Number of leaks, rate of bilateral involvement, and recurrence rate had a negative linear association with AL (p < 0.05). CONCLUSIONS AL appears to be the basic anatomical predictor, which associated with morphological and clinical characteristics in acute central serous chorioretinopathy.
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Semeraro F, Morescalchi F, Russo A, Gambicorti E, Pilotto A, Parmeggiani F, Bartollino S, Costagliola C. Central Serous Chorioretinopathy: Pathogenesis and Management. Clin Ophthalmol 2019; 13:2341-2352. [PMID: 31819359 PMCID: PMC6897067 DOI: 10.2147/opth.s220845] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 10/21/2019] [Indexed: 01/15/2023] Open
Abstract
Central serous chorioretinopathy (CSC) is a common retina disease and has a relative high recurrence rate, etiology, and pathogenesis of which remains largely ambiguous. The effects on the retina are usually self-limited, although some people are left with permanent vision loss due to progressive and irreversible photoreceptor damage or retinal pigment epithelium atrophy. There have been a number of interventions used in CSC, including, but not limited to, laser treatment, photodynamic therapy (PDT), intravitreal injection of anti-vascular endothelial growth factor agents, and subthreshold lasers. It is not clear whether there is a clinically important benefit to treating acute CSC, which often resolves spontaneously as part of its natural history. Of the interventions studied to date, PDT and micropulse laser treatment appear the most promising.
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Affiliation(s)
- Francesco Semeraro
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Francesco Morescalchi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Andrea Russo
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Elena Gambicorti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Andrea Pilotto
- Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Brescia, Italy
| | - Francesco Parmeggiani
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Silvia Bartollino
- Department of Medicine and Health Science "V. Tiberio", University of Molise, Campobasso, Italy
| | - Ciro Costagliola
- Department of Medicine and Health Science "V. Tiberio", University of Molise, Campobasso, Italy
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