Choroidal hyperpermeability patterns correlate with disease severity in central serous chorioretinopathy: CERTAIN study report 2
Acta Ophthalmologica, vol. 102, pp. e946–e955
Abstract
PURPOSE: Choroidal vascular hyperpermeability (CVH) on indocyanine green angiography (ICGA) is a hallmark feature of central serous chorioretinopathy (CSC). We identified three distinct CVH phenotypes in CSC: uni-focal indistinct signs of choroidal hyperpermeability (uni-FISH) with one focal area of CVH, multiple areas of focal CVH (multi-FISH), and diffuse hyperpermeability covering most of the posterior pole (DISH). This report investigates the distribution of these phenotypes and their association with signs of disease chronicity. METHODS: The CERTAIN study is a monocentric, retrospective study on consecutive CSC patients referred to a large tertiary referral centre that underwent ultra-widefield (UWF) and 55° ICGA. Two independent graders assessed CVH patterns based on mid- to late-phase UWF and 55° ICGA with a third grader acting as referee. RESULTS: Of the 167 eyes of 91 patients included in this study, 43 (26%) showed uni-FISH, 87 (52%) multi-FISH, and 34 (20%) showed DISH based on UWF ICGA. Median age (40 vs. 45 vs. 57; p < 0.001) and logMAR visual acuity (0 vs. 0 vs. 0.1, p < 0.001) differed significantly in-between groups, as did the occurrence of cystoid retinal degeneration (PCRD; 0% vs. 1% vs. 18%, p < 0.001) or diffuse atrophic RPE alterations (DARA; 0% vs. 17% vs. 29%, p < 0.001). The same was true when grading was based on 55° ICGA. CONCLUSIONS: The CVH patterns of uni-FISH, multi-FISH, and DISH are typical of CSC. These patterns correlate with established signs of CSC chronicity. Their predictive role in treatment response and prognosis remains to be evaluated.
Authors 6
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University Medical Center Hamburg-Eppendorf · Amsterdam University Medical Centers
Affiliation as printed
Department of Ophthalmology Amsterdam University Medical Centers Amsterdam The Netherlands
Department of Ophthalmology University Medical Center Hamburg‐Eppendorf Hamburg Germany
Department of Ophthalmology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Amsterdam University Medical Centers
Affiliation as printed
Department of Ophthalmology Amsterdam University Medical Centers Amsterdam The Netherlands
Department of Ophthalmology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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Jennifer M. Chang‐Wolf Aachen Department of Ophthalmology Leiden University Medical Center Leiden the Netherlands Department of Ophthalmology, Leiden University Medical Center
Leiden University Medical Center · Amsterdam University Medical Centers
Affiliation as printed
Department of Ophthalmology Amsterdam University Medical Centers Amsterdam The Netherlands
Department of Ophthalmology Leiden University Medical Center Leiden The Netherlands
Department of Ophthalmology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
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Amsterdam University Medical Centers
Affiliation as printed
Department of Ophthalmology Amsterdam University Medical Centers Amsterdam The Netherlands
Department of Ophthalmology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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Fondation Asile des Aveugles · Amsterdam University Medical Centers · University of Lausanne
Affiliation as printed
Department of Ophthalmology Amsterdam University Medical Centers Amsterdam The Netherlands
Department of Ophthalmology University of Lausanne, Jules‐Gonin Eye Hospital, Fondation Asile des Aveugles Lausanne Switzerland
Ocular Angiogenesis Group Amsterdam University Medical Centers Amsterdam The Netherlands
Department of Ophthalmology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland
Ocular Angiogenesis Group, Amsterdam University Medical Centers, Amsterdam, The Netherlands
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Elon H. C. van Dijk Aachen Department of Ophthalmology Leiden University Medical Center Leiden the Netherlands Department of Ophthalmology, Leiden University Medical Center
Leiden University Medical Center
Affiliation as printed
Department of Ophthalmology Leiden University Medical Center Leiden The Netherlands
Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
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