First Author: M.Karliychuk UKRAINE
Co Author(s): S. Pinchuk I. Konovalets O. Baryska
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To study the morphologic changes of outer nuclear layer (ONL) at the fovea and their relationship with visual acuity in patients with resolved acute form of central serous chorioretinopathy (CSC).
Bukovinian State Medical University, centre of Modern Ophthalmology “Vash Zir”, Chernivtsi, Ukraine.
The study comprised 26 patients (26 eyes) with acute form (fluid persisting <3 months) of central serous chorioretinopathy with subretinal fluid (SRF) resolution. 17 patients (17 eyes) received topical nonsteroidal anti-inflammatory drugs, topical and systemic carbonic anhydrase inhibitors, and nutritional supplements (lutein, zeaxanthin). 9 patients (9 eyes) were only observed. Patients underwent visual acuity testing, fundus examination, and spectral-domain optical coherence tomography (OCT) at every visit with the intervals of 3 to 4 weeks until SRF resolved. OCT (RTVue-100, Optovue, USA) was performed by acquiring six radial scans, 6 mm long, centreed in the fovea using the fast macular scan function. The outer nuclear layer thickness at the central fovea and integrity of the photoreceptor inner and outer segment junction were measured and assessed.
The average ONL thickness at the central 1-mm foveal zone was from 69.8 μm to 113.7 μm. In patients with visual acuity 0.4-0.5 and less the average ONL thickness at the central fovea was significantly (P < 0.01) thinner than that in patients with visual acuity 0.6-0.9. The ONL thickness was correlated with the visual acuity (r=0.61; p<0.001). All patients, in which the management choice was observation, had visual acuity 0.4-0.5 and less in spite of subretinal fluid resolution. Disorganization of the photoreceptor inner and outer segment junction integrity was observed in patients with visual acuity 0.3-0.4 and less, and was absent in patients with visual acuity 0.6-0.9.
The ONL thickness within central foveal zone is positively correlated with the visual acuity in resolved acute form of CSC. Disorganization of photoreceptor inner and outer segment junction within central foveal zone was observed in eyes with visual acuity 0.3-0.4 and less. Our results suggest that evaluation of outer nuclear layer morphology at the fovea may be used for predicting of visual outcome in acute form of central serous chorioretinopathy and for definition of instances when treatment instead of observation may be desirable.