The change of retinal microstructure and the correlation with visual outcome in central serous chorioretinopathy after laser treatment / 中华眼底病杂志

ABSTRACT

Objective To observe the change of retinal microstructures and the association between visual outcome with these microstructures in central serous chorioretinopathy (CSC) after laser treatment.Methods This is a retrospective study.From April 2016 to February 2017,a total of 52 eyes from 52 patients who underwent conventional laser treatment (27 eyes) or subthreshold laser treatment (25 eyes) for CSC and the sub-retinal fluid (SRF) absorbed completely were included in this study.The were 46 patients (46 eyes) and 6 males (6 eyes),with the mean age of 43.92± 8.62 years.The healthy fellow eyes (49 eyes) were selected as control.All patients were underwent BCVA and SD-OCT examination.According to the OCT images for all patients,the thickness of central foveal (CFT),outer nuclear (ONL),inner segment (IS),outer segment (OS) were measured.The status of ellipsoid zone (EZ),interdigitation zone (IZ) and RPE were also evaluated at fovea.Comparing the change of SD-OCT microstructures in two time points,the first visit after SRF absorbed and the last visit respectively.Spearman correlation analysis was used to analyze the relation between BCVA and ONL,IS,OS.Results At the first visit after SRF absorbed,compared with control eyes,the thickness of CFT (182.55 ± 24.14 μm),ONL (72.86 ± 17.39 μm),IS (41.23 ± 5.14 μm),OS (18.52 ± 10.26 μm) in CSC eyes were decreased (P＜ 0.001).Meanwhile,the mean BCVA of CSC eyes was 81.27± 6.39 letters,which was also significantly decreased comparing with control eyes (P＜ 0.001).At last visit,the thickness of CFT,ONL,IS,OS were 195.19±22.10,75.44±16.33,44.56±4.09,26.60± 11.39 μm,and the mean BCVA was 85.50±5.95 letters.All recovered significantly comparing with first visit (P＜0.05).At first visit,the BCVA of patients with integrate EZ (83.38± 5.78 letters) was significantly better than the BCVA of patients with unintegrated EZ (77.90± 5.97 letters) (P=0.003).And the BCVA of patients with smooth RPE (82.72± 5.95 letter) was also significantly better than the BCVA of patients with rough RPE (78.00± 6.31 letters) (P=0.020).The result of Spearman correlation analysis showed that the thickness of OS was positively correlated to BCVA at two time points (r=0.423,0.416;P=0.002,0.002).Conclusions In CSC,the thickness of ONL,IS,OS were decreased,and the integrality of EZ,IZ,the smooth of RPE were disrupted in different extent.After laser treatment,with retinal reattachment,those microstructures including ONL,IS,OS,EZ,IZ recovered slowly.The thickness of OS,the integrality of EZ and the smooth of RPE were associated with visual acuity.