One-year follow-up of choroidal and macular thickness in acute non-treated central serous chorioretinopathy.

CLINICAL RELEVANCE: Choroidal and macular thickness assessments are essential to understand the evolution of central serous chorioretinopathy and could help in identifying patients more prone to recurrence. BACKGROUND: The aim of this work was to evaluate changes in the choroidal thickness and macular thickness in acute non-treated central serous chorioretinopathy during a one-year follow-up. METHODS: A prospective longitudinal study of 38 patients with central serous chorioretinopathy and 35 healthy controls at a tertiary care facility (Fundación Alcorcón University Hospital) was conducted. Choroidal and macular thicknesses were measured using enhanced-depth-imaging optical coherence tomography and subretinal fluid resolution and best-corrected visual acuity were evaluated, at baseline and 1, 3, 6 and 12 months. Prognostic factors determining the need for treatment were evaluated. RESULTS: Choroidal thickness decreased in eyes with central serous chorioretinopathy (p < 0.001) but not in fellow eyes (p = 0.24) during one-year follow-up since the acute episode. The estimated mean choroidal thickness in symptomatic eyes was 465 µm (SE: 17.18) at baseline and decreased 58.1 µm (CI 95%: 30.1-85.9) at 12 months (p < 0.001). Best-corrected visual acuity improved over time (p = 0.037), with a decrease of logMAR 0.086 (CI95%: 0-0.172).The macular thickness changed over time (p < 0.001), with a decrease from baseline of 124.6 µm (CI95%: 61.4-187.9). Subretinal fluid resolved in 67% (CI 95%: 51-82) of patients at 6 months. There was no significant association between baseline choroidal thickness, macular thickness, best-corrected visual acuity, age or sex and the need for treatment. CONCLUSIONS: The choroidal thickness decreased in acute central serous chorioretinopathy episodes during a one-year follow-up. Subretinal fluid persisted in less than 20% of patients at the end of the one-year follow-up. No prognostic factors determining the need for treatment were found.

Sensitivity and specificity of choroidal thickness measurement by EDI-OCT for central serous chorioretinopathy diagnosis.

PURPOSE: To evaluate the utility of choroidal thickness (CT) measurement by enhanced depth imaging optical coherence tomography (EDI-OCT) for central serous chorioretinopathy (CSC) diagnosis. METHODS: Cross-sectional comparative study of 62 consecutive patients: 38 with acute CSC and 24 with macular subretinal fluid from differential diagnoses (DD). Subfoveolar choroidal thickness was measured using EDI 9-mm horizontal protocol. We evaluated sensitivity, specificity and intraclass correlation coefficient. RESULTS: Mean subfoveolar CT was greater in CSC group than in DD group (465.45 ± 115.42 µm vs. 347.54 ± 111.27 µm, p < 0.001). The best threshold measure was 390 µm in patients younger than 50 years giving a sensitivity of 89.7% (CI 95%: 73.6-100%) and a specificity of 75% (CI 95%: 40.9-87.3%). For patients older than 50 years best threshold measure was found at 400 µm giving a sensitivity of 45.5% (CI 95%: 21.3-72%) and a specificity of 80% (CI 95%: 58.4-91.9%). Intraclass correlation coefficient for CT measurement was 0.87 (CI 95%: 0.74-0.93). CONCLUSION: CT measurement with EDI-OCT helps to differentiate CSC from other causes of macular subretinal fluid in patients younger than 50 years.

Solitary congenital hypertrophy of the retinal pigment epithelium features by high-definition optical coherence tomography.

PURPOSE: To describe the features of solitary congenital hypertrophy of the retinal pigment epithelium (CHRPE) using high-definition optical coherence tomography (HD-OCT). METHODS: This was a retrospective, observational, noncomparative case series including 16 consecutive patients with solitary CHRPE. We describe the clinical and OCT features of CHRPE using the 5 radial lines acquisition OCT protocol over the CHRPE and the retina next to the tumor. RESULTS: The mean patient age was 54 years (median 57 years; range 8-76 years). The CHRPE lesion was outside the posterior pole in 14 of the patients (8 temporal, 3 superior, 2 nasal, and 1 inferior quadrant) and 2 peripapillary. Fifteen patients (94%) showed retinal thinning and complete photoreceptor loss overlying the CHRPE. The RPE hyperreflectivity was found in all patients. The retina over the lesion measured a mean of 60.3% (range 41%-95%) of the thickness of the adjacent normal retina. CONCLUSIONS: High-definition OCT showed retinal thinning, photoreceptor loss, and RPE hyperreflectivity in solitary CHRPE lesions.

Sensitivity and specificity of monochromatic photography of the ocular fundus in differentiating optic nerve head drusen and optic disc oedema: optic disc drusen and oedema.

BACKGROUND: Evaluation of the efficacy of monochromatic photography of the ocular fundus in differentiating optic nerve head drusen (ONHD) and optic disc oedema (ODE). METHODS: Sixty-six patients with ONHD, 31 patients with ODE and 70 healthy subjects were studied. Colour and monochromatic fundus photography with different filters (green, red and autofluorescence) were performed. The results were analysed blindly by two observers. The sensitivity, specificity and interobserver agreement (k) of each test were assessed. RESULTS: Colour photography offers 65.5 % sensitivity and 100 % specificity for the diagnosis of ONHD. Monochromatic photography improves sensitivity and specificity and provides similar results: green filter (71.20 % sensitivity, 96.70 % specificity), red filter (80.30 % sensitivity, 96.80 % specificity), and autofluorescence technique (87.8 % sensitivity, 100 % specificity). The interobserver agreement was good with all techniques used: autofluorescence (k = 0.957), green filter (k = 0.897), red filter (k = 0.818) and colour (k = 0.809). CONCLUSIONS: Monochromatic fundus photography permits ONHD and ODE to be differentiated, with good sensitivity and very high specificity. The best results were obtained with autofluorescence and red filter study.