Long-term Visual Outcomes and Causes of Vision Loss in Chronic Central Serous Chorioretinopathy

Sarah Mrejen, Chandrakumar Balaratnasingam, Talia R. Kaden, Alexander Bottini, Kunal Dansingani, Kavita Bhavsar, Nicolas A. Yannuzzi, Samir Patel, Kevin C. Chen, Suqin Yu, Guillaume Stoffels, Richard F. Spaide, K. Bailey Freund, Lawrence A. Yannuzzi

Research output: Contribution to journalArticle

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Abstract

Purpose: To evaluate the long-term visual outcomes and causes of vision loss in chronic central serous chorioretinopathy (CSC). Design: Retrospective, longitudinal study. Participants: A total of 133 participants (217 eyes) with chronic CSC. Methods: A retrospective review of clinical and multimodal imaging data of patients with chronic CSC managed by 3 of the authors between May 1977 and March 2018. Multimodal imaging comprised color photography, fluorescein angiography, indocyanine green angiography, fundus autofluorescence (FAF), and OCT. Main Outcome Measures: Best-corrected visual acuity (BCVA) at the final visit; change in BCVA between first visit and 1-, 5-, and 10-year follow-up visits; and causes of vision loss at final visit. Results: Data from 6228 individual clinic visits were analyzed. Mean age of patients at the first visit was 60.7 years, and mean period of follow-up from first to last visit was 11.3 years. The cohort included 101 male patients (75.9%). At the final visit, 106 patients (79.7%) maintained driving-standard vision with BCVA of 20/40 or better in at least 1 eye, and 17 patients (12.8%) were legally blind with BCVA of 20/200 or worse in both eyes. Mean BCVA at first visit was not significantly different from mean BCVA at 1- or 5-year follow-up visits (both P ≥ 0.65) but was significantly better than the mean BCVA at the 10-year follow-up visit (P = 0.04). Seventy-nine percent of eyes with 20/40 or better vision at the first visit maintained the same level of vision at the 10-year follow-up visit. Ninety-two percent of eyes with 20/200 or worse vision at the first visit maintained the same level of vision at the 10-year follow-up visit. Cystoid macular degeneration, choroidal neovascularization (CNV), outer retinal disruption on OCT, and FAF changes were associated with poorer vision at the final visit (all P ≤ 0.001). Multivariable analysis revealed that greater age at first visit was associated with greater BCVA change at the 10-year follow-up visit (P = 0.001). Conclusions: Chronic CSC can be a sight-threatening disease leading to legal blindness. Age at presentation and outer retinal changes on multimodal imaging were associated with long-term BCVA changes and may be predictors of long-term visual outcomes.

Original languageEnglish (US)
JournalOphthalmology
DOIs
StatePublished - Jan 1 2019

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Central Serous Chorioretinopathy
Visual Acuity
Multimodal Imaging
Choroidal Neovascularization
Indocyanine Green
Fluorescein Angiography
Photography
Macular Degeneration
Blindness
Ambulatory Care
Longitudinal Studies
Angiography
Retrospective Studies
Color
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Ophthalmology

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Long-term Visual Outcomes and Causes of Vision Loss in Chronic Central Serous Chorioretinopathy. / Mrejen, Sarah; Balaratnasingam, Chandrakumar; Kaden, Talia R.; Bottini, Alexander; Dansingani, Kunal; Bhavsar, Kavita; Yannuzzi, Nicolas A.; Patel, Samir; Chen, Kevin C.; Yu, Suqin; Stoffels, Guillaume; Spaide, Richard F.; Freund, K. Bailey; Yannuzzi, Lawrence A.

In: Ophthalmology, 01.01.2019.

Research output: Contribution to journalArticle

Mrejen, S, Balaratnasingam, C, Kaden, TR, Bottini, A, Dansingani, K, Bhavsar, K, Yannuzzi, NA, Patel, S, Chen, KC, Yu, S, Stoffels, G, Spaide, RF, Freund, KB & Yannuzzi, LA 2019, 'Long-term Visual Outcomes and Causes of Vision Loss in Chronic Central Serous Chorioretinopathy', Ophthalmology. https://doi.org/10.1016/j.ophtha.2018.12.048
Mrejen, Sarah ; Balaratnasingam, Chandrakumar ; Kaden, Talia R. ; Bottini, Alexander ; Dansingani, Kunal ; Bhavsar, Kavita ; Yannuzzi, Nicolas A. ; Patel, Samir ; Chen, Kevin C. ; Yu, Suqin ; Stoffels, Guillaume ; Spaide, Richard F. ; Freund, K. Bailey ; Yannuzzi, Lawrence A. / Long-term Visual Outcomes and Causes of Vision Loss in Chronic Central Serous Chorioretinopathy. In: Ophthalmology. 2019.
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abstract = "Purpose: To evaluate the long-term visual outcomes and causes of vision loss in chronic central serous chorioretinopathy (CSC). Design: Retrospective, longitudinal study. Participants: A total of 133 participants (217 eyes) with chronic CSC. Methods: A retrospective review of clinical and multimodal imaging data of patients with chronic CSC managed by 3 of the authors between May 1977 and March 2018. Multimodal imaging comprised color photography, fluorescein angiography, indocyanine green angiography, fundus autofluorescence (FAF), and OCT. Main Outcome Measures: Best-corrected visual acuity (BCVA) at the final visit; change in BCVA between first visit and 1-, 5-, and 10-year follow-up visits; and causes of vision loss at final visit. Results: Data from 6228 individual clinic visits were analyzed. Mean age of patients at the first visit was 60.7 years, and mean period of follow-up from first to last visit was 11.3 years. The cohort included 101 male patients (75.9{\%}). At the final visit, 106 patients (79.7{\%}) maintained driving-standard vision with BCVA of 20/40 or better in at least 1 eye, and 17 patients (12.8{\%}) were legally blind with BCVA of 20/200 or worse in both eyes. Mean BCVA at first visit was not significantly different from mean BCVA at 1- or 5-year follow-up visits (both P ≥ 0.65) but was significantly better than the mean BCVA at the 10-year follow-up visit (P = 0.04). Seventy-nine percent of eyes with 20/40 or better vision at the first visit maintained the same level of vision at the 10-year follow-up visit. Ninety-two percent of eyes with 20/200 or worse vision at the first visit maintained the same level of vision at the 10-year follow-up visit. Cystoid macular degeneration, choroidal neovascularization (CNV), outer retinal disruption on OCT, and FAF changes were associated with poorer vision at the final visit (all P ≤ 0.001). Multivariable analysis revealed that greater age at first visit was associated with greater BCVA change at the 10-year follow-up visit (P = 0.001). Conclusions: Chronic CSC can be a sight-threatening disease leading to legal blindness. Age at presentation and outer retinal changes on multimodal imaging were associated with long-term BCVA changes and may be predictors of long-term visual outcomes.",
author = "Sarah Mrejen and Chandrakumar Balaratnasingam and Kaden, {Talia R.} and Alexander Bottini and Kunal Dansingani and Kavita Bhavsar and Yannuzzi, {Nicolas A.} and Samir Patel and Chen, {Kevin C.} and Suqin Yu and Guillaume Stoffels and Spaide, {Richard F.} and Freund, {K. Bailey} and Yannuzzi, {Lawrence A.}",
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T1 - Long-term Visual Outcomes and Causes of Vision Loss in Chronic Central Serous Chorioretinopathy

AU - Mrejen, Sarah

AU - Balaratnasingam, Chandrakumar

AU - Kaden, Talia R.

AU - Bottini, Alexander

AU - Dansingani, Kunal

AU - Bhavsar, Kavita

AU - Yannuzzi, Nicolas A.

AU - Patel, Samir

AU - Chen, Kevin C.

AU - Yu, Suqin

AU - Stoffels, Guillaume

AU - Spaide, Richard F.

AU - Freund, K. Bailey

AU - Yannuzzi, Lawrence A.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Purpose: To evaluate the long-term visual outcomes and causes of vision loss in chronic central serous chorioretinopathy (CSC). Design: Retrospective, longitudinal study. Participants: A total of 133 participants (217 eyes) with chronic CSC. Methods: A retrospective review of clinical and multimodal imaging data of patients with chronic CSC managed by 3 of the authors between May 1977 and March 2018. Multimodal imaging comprised color photography, fluorescein angiography, indocyanine green angiography, fundus autofluorescence (FAF), and OCT. Main Outcome Measures: Best-corrected visual acuity (BCVA) at the final visit; change in BCVA between first visit and 1-, 5-, and 10-year follow-up visits; and causes of vision loss at final visit. Results: Data from 6228 individual clinic visits were analyzed. Mean age of patients at the first visit was 60.7 years, and mean period of follow-up from first to last visit was 11.3 years. The cohort included 101 male patients (75.9%). At the final visit, 106 patients (79.7%) maintained driving-standard vision with BCVA of 20/40 or better in at least 1 eye, and 17 patients (12.8%) were legally blind with BCVA of 20/200 or worse in both eyes. Mean BCVA at first visit was not significantly different from mean BCVA at 1- or 5-year follow-up visits (both P ≥ 0.65) but was significantly better than the mean BCVA at the 10-year follow-up visit (P = 0.04). Seventy-nine percent of eyes with 20/40 or better vision at the first visit maintained the same level of vision at the 10-year follow-up visit. Ninety-two percent of eyes with 20/200 or worse vision at the first visit maintained the same level of vision at the 10-year follow-up visit. Cystoid macular degeneration, choroidal neovascularization (CNV), outer retinal disruption on OCT, and FAF changes were associated with poorer vision at the final visit (all P ≤ 0.001). Multivariable analysis revealed that greater age at first visit was associated with greater BCVA change at the 10-year follow-up visit (P = 0.001). Conclusions: Chronic CSC can be a sight-threatening disease leading to legal blindness. Age at presentation and outer retinal changes on multimodal imaging were associated with long-term BCVA changes and may be predictors of long-term visual outcomes.

AB - Purpose: To evaluate the long-term visual outcomes and causes of vision loss in chronic central serous chorioretinopathy (CSC). Design: Retrospective, longitudinal study. Participants: A total of 133 participants (217 eyes) with chronic CSC. Methods: A retrospective review of clinical and multimodal imaging data of patients with chronic CSC managed by 3 of the authors between May 1977 and March 2018. Multimodal imaging comprised color photography, fluorescein angiography, indocyanine green angiography, fundus autofluorescence (FAF), and OCT. Main Outcome Measures: Best-corrected visual acuity (BCVA) at the final visit; change in BCVA between first visit and 1-, 5-, and 10-year follow-up visits; and causes of vision loss at final visit. Results: Data from 6228 individual clinic visits were analyzed. Mean age of patients at the first visit was 60.7 years, and mean period of follow-up from first to last visit was 11.3 years. The cohort included 101 male patients (75.9%). At the final visit, 106 patients (79.7%) maintained driving-standard vision with BCVA of 20/40 or better in at least 1 eye, and 17 patients (12.8%) were legally blind with BCVA of 20/200 or worse in both eyes. Mean BCVA at first visit was not significantly different from mean BCVA at 1- or 5-year follow-up visits (both P ≥ 0.65) but was significantly better than the mean BCVA at the 10-year follow-up visit (P = 0.04). Seventy-nine percent of eyes with 20/40 or better vision at the first visit maintained the same level of vision at the 10-year follow-up visit. Ninety-two percent of eyes with 20/200 or worse vision at the first visit maintained the same level of vision at the 10-year follow-up visit. Cystoid macular degeneration, choroidal neovascularization (CNV), outer retinal disruption on OCT, and FAF changes were associated with poorer vision at the final visit (all P ≤ 0.001). Multivariable analysis revealed that greater age at first visit was associated with greater BCVA change at the 10-year follow-up visit (P = 0.001). Conclusions: Chronic CSC can be a sight-threatening disease leading to legal blindness. Age at presentation and outer retinal changes on multimodal imaging were associated with long-term BCVA changes and may be predictors of long-term visual outcomes.

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