Fundus imaging features of glucocorticoid-related central serous chorioretinopathy
10.3760/cma.j.cn511434-20241008-00373
- VernacularTitle:糖皮质激素相关中心性浆液性脉络膜视网膜病变眼底影像特征
- Author:
Bo JIN
1
;
Pei LIU
;
Shu LI
;
Chenyu LU
;
Guangqi AN
;
Haiyan ZHU
;
Liping DU
;
Xuemin JIN
Author Information
1. 郑州大学第一附属医院 河南省眼科医院 郑州大学医学科学院, 郑州 450003
- Publication Type:Journal Article
- Keywords:
Central serous chorioretinopathy;
Glucocorticoid;
Swept-source optical coherence tomography;
Choroidal thickness;
Subretinal fibrosis
- From:
Chinese Journal of Ocular Fundus Diseases
2025;41(5):358-363
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare and observe the fundus imaging characteristics of eyes with glucocorticoid-related central serous chorioretinopathy (CSC).Methods:A retrospective clinical study. A total of 149 CSC patients with 166 eyes diagnosed at Department of Ophthalmology of The First Affiliated Hospital of Zhengzhou University from March 2021 to October 2024 were included in the study. The duration of the disease from the appearance of symptoms to treatment was less than 3 months. All affected eyes underwent best-corrected visual acuity (BCVA), fundus color photography, swept-source optical coherence tomography (SS-OCT), and fundus fluorescein angiography (FFA) examinations. BCVA was tested using an international standard vision chart and converted into logarithm of the minimum angle of resolution (logMAR) visual acuity for statistical analysis. The SS-OCT instrument measured subfoveal choroidal thickness (SFCT), central macular thickness (CMT), choroidal vascular volume (CVV), and the width and height of flat irregular pigment epithelial detachment (FIPED). FIPED, subretinal fibrin, and choroidal layer strong reflective spots were identified from SS-OCTA B-scan images; multiple leakages (leak points >3) were identified from FFA images. Based on the presence or absence of a clear history of glucocorticoid administration before the onset, patients were divided into glucocorticoid-related and non-glucocorticoid-related groups, comprising 41 patients with 53 eyes and 108 patients with 113 eyes, respectively. Clinical and fundus imaging characteristics of the two groups were compared. The comparison of quantitative data between the two groups was performed using independent samples t test or non-parametric independent samples Wilcoxon test; the comparison of qualitative data was performed using χ2 test. Results:Compared with the non-glucocorticoid-related group, the glucocorticoid-related group had a smaller male-to-female ratio and a higher bilateral incidence, and the differences were statistically significant ( χ2=4.925, 17.849; P<0.05). The logMAR BCVA for the glucocorticoid-related and non-glucocorticoid-related groups were 0.45±0.33 and 0.21±0.21, respectively; SFCT were (644.43±131.91) and (507.26±121.79) μm; CMT were (389.51±233.45) and (362.59±140.85) μm; CVV were (4.44±1.07) and (3.67±0.82) mm 3; FIPED incidence were 58.49% (31/58) and 20.35% (23/113), respectively; FIPED width and height were (1 122.01±533.98) and (742.90±388.79) μm, and (99.13±92.17) and (33.01±15.99) μm; subretinal fibrin were observed in 24 (45.28%, 24/53) and 15 (13.27%, 15/113) eyes; choroidal strong reflections were found in 38 (71.70%, 38/53) and 45 (39.82%, 45/113) eyes; multiple leak points were identified in 35 (66.03%, 35/53) and 40 (35.40%, 40/113) eyes, respectively. Compared with the non-glucocorticoid-related group, the glucocorticoid-related group had worse BCVA ( Z=-4.984), thicker SFCT ( t=6.586), larger CVV ( t=5.160), higher incidence of FIPED ( χ2=23.908), and greater width and height of FIPED ( t=2.895, Z=-3.703). The glucocorticoid-related group also had a significantly increased incidence of subretinal fibrin, choroidal strong reflections, and multiple leak points, with all differences being statistically significant ( χ2=20.565, 14.663, 13.675; P<0.05); however, the comparison of CMT showed no statistically significant difference ( Z=-0.651, P>0.05). Conclusion:Compared with non-glucocorticoid-related CSC, glucocorticoid-related CSC patients have poorer vision, are more likely to affect both eyes, show no gender bias; choroidal vascular dilation is more significant, and damage to the outer retina and retinal pigment epithelium is more severe.
