CORRELATIONS BETWEEN CHANGES IN PHOTORECEPTOR LAYER AND OTHER CLINICAL CHARACTERISTICS IN CENTRAL SEROUS CHORIORETINOPATHY

Abstract

Purpose: To clarify the correlations between changes in the photoreceptor layer (PRL) and other clinical characteristics during central serous chorioretinopathy.

Methods: Patients with central serous chorioretinopathy with one eye affected were enrolled. Photoreceptor layer appearance within the detached area was evaluated, and its correlations with symptom duration, best-corrected visual acuity, and the difference in the foveal outer nuclear layer thickness between the affected and contralateral eyes were analyzed.

Results: A total of 222 patients were included. The PRL outer border appeared either smooth, granulated, or as scattered dots attached to external limiting membrane. These different appearances were associated with elongation in symptom duration (18, 180, and 1,855 days), decreases in best-corrected visual acuity (6/10, 6/15, and 6/120), and increases in the difference of foveal outer nuclear layer thickness (-16, -32, and -60 μm). Among eyes with smooth PRL outer border, which had similar symptom duration, eyes with foveal PRL defect had poorer best-corrected visual acuity and greater reduction in outer nuclear layer thickness than the other eyes (all P = 0.00).

Conclusion: Morphologic changes in PRL, best-corrected visual acuity, the reduction in foveal outer nuclear layer thickness, and symptom duration correlate closely but may behave asynchronously. These objective parameters, besides symptom duration, could be helpful when considering the timing of central serous chorioretinopathy treatment.

Fig. 1.

Various appearances of the PRL within the detached area in active CSC (A–F). A. Line scan of a 28-year-old female patient with BCVA of 6/6 and symptom duration of 6 days; the outer border of the PRL was smooth and intact. B. Line scan of a 42-year-old male patient with BCVA of 6/6 and symptom duration of 14 days; the outer border of PRL was smooth and thickened, with a PRL defect involving the temporal part. C. Line scan of a 42-year-old male patient with BCVA of 6/30 and symptom duration of 40 days; the outer border of the PRL was smooth and thickened, with a PRL defect involving the fovea. D. Line scan of a 41-year-old male patient with BCVA of 6/20 and symptom duration of 91 days; the outer border of the PRL was granulated. E. Line scan of a 49-year-old male patient with BCVA of 6/12 and symptom duration of 540 days; the outer border of the PRL was granulated, with the foveal PRL protruding. F. Line scan of a 54-year-old male patient with BCVA of 6/60 and symptom duration of 1,883 days; the PRL presented as scattered dots attached to the external limiting membrane.