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
To describe recurrence patterns and investigate candidate risk factors for recurrences of central serous chorioretinopathy (CSCR).
Observational case series in a tertiary retinal referral centre.
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.
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.
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.