Central serous chorioretinopathy (CSCR) recurrence risk factors include a history of corticosteroid use, bilateral disease, chronic manifestations, nonintense fluorescein leakage and thin initial central retinal thickness (CRT), according to an Acta Ophthalmologica published study that employed optical coherence tomography angiography (OCT-A) imaging.
Researchers retrospectively reviewed 538 eyes from 538 patients diagnosed with CSCR (mean age 53.4±11.9 years, 402 men, 136 women). Participants were examined at 9 medical institutions in Japan between May 2008 and September 2020. The team evaluated demographic data and medical history. They analyzed significant differences in chronic manifestation, leakage site, leakage point number, leakage intensity, choroidal hyperpermeability, CRT and subfoveal choroidal thickness between the recurrence and nonrecurrence groups.
The researchers found that 253 eyes (47.0%) experienced at least 1 recurrence, with a mean number of recurrences per case of 1.38±0.59 (range: 1-5) during a follow-up of 15.8±13.4 months (range: 3-86 months).
Univariate and multivariate analysis revealed that a history of corticosteroid use (OR, 5.52; 95% CI, 1.39-21.92; P =.015), presence of bilateral disease (OR, 3.94; 95% CI, 1.47–10.6; P =.007), chronic manifestations (OR, 7.12; 95% CI, 2.93-17.28; P <.001), nonintense fluorescein leakage, (OR, 3.34; 95% CI, 1.44-7.75; P =.005) and initial CRT (OR, 0.997; 95% CI, 0.993-0.999; P =.049) were significantly associated with CSCR recurrence. The mean CRT measured at the initial visit for the patients who did not experience nonrecurrence was 385.8±152.0 µm, while the patients who did experience recurrance had a mean CRT of 357.2±134.7 µm (P =.025).
“[CSCR] recurrence can be predicted by a history of corticosteroid use, bilateral disease, chronic manifestation, nonintense fluorescein leakage and the initial CRT,” according to the researchers. “Early recognition of the possible risk factors is essential for preventing [CSCR] recurrence, and patients at high risk for recurrence require careful treatment and frequent surveillance to avoid deterioration of vision.”
Limitations of the study include its retrospective nature, the relatively short follow-up time and no evaluation of systemic risk factors such as hypertension, allergic disease and psychiatric disease.
Zhou X, Komuku Y, Araki T, et al. A multicentre study of the risk factors associated with recurrence of central serous chorioretinopathy. Acta Ophthalmol. Published online May 28, 2022. doi:10.1111/aos.15194