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Central serous chorioretinopathy in elderly subjects: angiographic and tomographic characteristics

  • Kunho Bae
  • Seung Wan Nam
  • Se Woong KangEmail author
  • Eung Suk Kim
  • Seung-Young Yu
  • Kyung Tae Kim
  • Sang Jin Kim
Retinal Disorders
  • 47 Downloads

Abstract

Purpose

To investigate the angiographic, tomographic, and clinical characteristics of idiopathic central serous chorioretinopathy (CSC) in elderly patients.

Methods

The patients were divided into two groups according to a cutoff age of 60 years at baseline. Patients underwent spectral domain optical coherence tomography, fluorescein angiography, and indocyanine green angiography. Angiographic and tomographic features were compared between the two groups (young vs. elderly group).

Results

Of 176 patients, 26 patients (15.1%) were 60 years or older. Complete resolution of subretinal fluid after treatment was noted in 72.0% of the elderly group and 90.8% of the young group (P = 0.021). The elderly group showed worse baseline and final vision, more bilateral involvement, and lower male preponderance than the young group (P < 0.05, respectively). The elderly group was also associated with a higher frequency of retinal pigment epithelium depigmentation, foveal thinning, and double-layer sign compared with the young group (P < 0.05, respectively).

Conclusion

CSC in elderly patients was associated with a lower resolution of serous detachment, increased impairment of retinal pigment epithelial layers, foveal thinning, and worse visual outcome, suggesting a chronic insult to the choroidal vessels involving more severe damage to the outer retinal layers.

Keywords

Central serous chorioretinopathy Fluorescein angiography Indocyanine green angiography Imaging Optical coherence tomography Pachychoroid Photo dynamic therapy Polypoidal choroidal vasculopathy 

Notes

Acknowledgements

The authors thank statistician Soo Hyun Ahn, Ph.D., Department of Biomedical statistics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Funding

This work was supported by a grant from the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (NRF-2017R1D1A1B03034695). The sponsor or funding organization had no role in the design or conduct of this research.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

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ESM 1

(PNG 2379 kb)

417_2018_4201_MOESM1_ESM.tif (3.3 mb)
High resolution image (TIF 3411 kb)
417_2018_4201_MOESM2_ESM.xlsx (69 kb)
Supplemental Digital Content 1 Representative images of angiographic and tomographic findings of central serous chorioretinopathy. a Depigmentation of retinal pigment epithelium (RPE) was defined as depigmentation or reactive hyperpigmentation with a size larger than 1/8 disc diameter on fundus photography. b A demarcation line demonstrates delayed patch choroidal filling in early phase. c Late indocyanine green angiography (ICGA) illustrating multiple hyperfluorescent spots together with areas of choroidal hyperpermeability. e Optical coherence tomography (OCT) shows a double layer sign that is defined as two highly reflective layers visible at the RPE layer. f Hyper-reflective foci were defined as discrete and well-circumscribed dots whose hyper-reflectivity was equal to or higher than that of the RPE band. Hyper-reflective foci were also observed in the subretinal space and the sub-RPE area. g Pigment epithelial detachment was defined as a dome-shaped protrusion of the RPE within the sub-RPE hyporeflective space. (XLSX 69 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of OphthalmologyDongguk University, Ilsan HospitalGoyangSouth Korea
  2. 2.Department of Ophthalmology, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  3. 3.Department of Ophthalmology, Kyung Hee University HospitalKyung Hee UniversitySeoulSouth Korea
  4. 4.Department of Ophthalmology, Chungbuk National University HospitalChungbuk UniversityCheongjuSouth Korea

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