Researchers in Poland have deemed central serous chorioretinopathy (CSC) a potentially serious ophthalmological disease that can lead to significant visual impairment, retinal thinning and choroidal flow defects. They found the condition led to decreased final best-corrected visual acuity (BCVA), a significantly thinner central retina and impaired choroidal perfusion, even following the remission of symptoms.
The study evaluated the damage present after long-standing but resolved CSC in 32 eyes that had complete resolution of subretinal fluid after subthreshold micropulse laser treatment. They compared the final BCVA and retinal morphological parameters measured by OCT angiography (OCT-A) with those of 40 control eyes that never underwent laser treatment.
Final BCVA after chronic CSC was 0.23 logMAR (0.6 Snellen) and central retinal thickness was 39.32μm smaller than in controls. The researchers compared this visual defect, if unilateral, to moderate anisometropic amblyopia. Affected patients may have peripheral stereopsis, which enables normal everyday activity; however, more demanding visual tasks have to be conducted with the use of the unaffected eye.
They found no correlation between final visual acuity and retinal thickness or duration of the disease, patient age and baseline morphological retinal parameters. OCT-A scans revealed impaired choriocapillary flow signal even following resolution of the disease. The researchers believe that disturbing the choroidal perfusion in this area also affects the outer retina and photoreceptors, causing a loss of the retinal pigment epithelium and photoreceptors, which could explain the functional damage.
Because major damage might occur within the first months of the disease, the researchers believe prompt treatment of CSC is necessary, rather than waiting for spontaneous remission, as it has been recommended in previous years.
|Gawęcki M, Jaszczuk-Maciejewska A, Jurska-Jaśko A, et al. Impairment of visual acuity and retinal morphology following resolved chronic central serous chorioretinopathy. BMC Ophthalmol. July 25, 2019. [Epub ahead of print].|