Risk factors for recurrences of central serous chorioretinopathy

Session Details

Session Title: Free Paper Session 11: Vascular Diseases & Diabetic Retinopathy III

Session Date/Time: Friday 08/09/2017 | 11:00-12:30

Paper Time: 12:00

Venue: Room 114

First Author: : A.Matet SWITZERLAND

Co Author(s): :    A. Daruich   M. Zola   F. Behar Cohen                       

Abstract Details

Purpose:

To describe recurrence patterns and investigate candidate risk factors for recurrences of central serous chorioretinopathy (CSCR).

Setting:

Observational case series in a tertiary retinal referral centre.

Methods:

In 46 patients with acute CSCR and follow-up >12 months after first episode resolution, parameters influencing recurrences were retrospectively evaluated using a frailty Cox proportional hazard survival model. Covariates included baseline systemic findings: age, gender, corticosteroid use, stress, shift work, sleep disorder, depression, allergy, cardiovascular risk; baseline optical coherence tomography findings: subfoveal choroidal thickness (SFCT), pigment epithelial detachment (PED) pattern (regular/bump/irregular), number of subretinal hyperreflective foci at leakage site; baseline angiographic findings: fluorescein leakage intensity (intense/moderate/subtle/absent), hyperpermeability pattern on indocyanine-green angiography (focal/multifocal); and episode-related findings: duration and treatment of previous episode.

Results:

Twenty of 46 subjects (43%) presented ≥1 recurrences during a mean follow-up of 29.9±9.5 months [range, 15-54 months]. Follow-up duration did not differ between cases with or without recurrences (P=0.3). Worse final visual acuity levels (logarithm of the minimal angle of resolution) were associated with a higher number of episodes during follow-up (P=0.032, r=0.28). In a univariate analysis, higher SFCT (P=0.021), non-intense fluorescein leakage (=moderate/subtle/absent, P=0.033), multiple subretinal hyperreflective foci (P=0.026), and shift work (P<0.0001) were significantly associated with recurrences, with a near-significant influence of irregular PED (P=0.093). In a multivariate analysis, higher SFCT (P=0.007), non-intense fluorescein leakage (P=0.003) and shift work (P<0.0001) remained significant and independent risk factors for recurrences.

Conclusions:

Multiple factors influence the risk of CSCR recurrence. These findings may contribute to identify patients at higher risk, who could benefit from earlier or more intensive treatment.

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