Long-term Visual Outcomes and Causes of Vision Loss in Chronic Central Serous Chorioretinopathy
Long-term Visual Outcomes and Causes of Vision Loss in Chronic Central Serous Chorioretinopathy
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DOI：
10.1016/j.ophtha.2018.12.048
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发表时间：
2019-04-01
期刊：
影响因子：
13.7
通讯作者：
Yannuzzi, Lawrence A.
中科院分区：
文献类型：
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作者：
Mrejen, Sarah;Balaratnasingam, Chandrakumar;Yannuzzi, Lawrence A.
目的：探讨慢性中枢性浆液性脉络膜视网膜病变（CSC）患者视力丧失的原因及远期预后。设计：回顾性、纵向研究。参与者：共有133名慢性CSC患者（217只眼）。方法：回顾性分析1977年5月至2018年3月期间3名作者管理的慢性CSC患者的临床和多模态影像学资料。多模态成像包括彩色摄影、荧光素血管造影、吲哚菁绿血管造影、眼底自身荧光（FAF）和oct。主要观察指标：最后一次就诊时最佳矫正视力（BCVA）；首次访视与1年、5年和10年随访期间BCVA的变化；以及最后一次就诊时视力丧失的原因。结果：分析了6228例个体门诊就诊数据。患者初访时平均年龄为60.7岁，初访至末访平均随访时间为11.3年。该队列包括101例男性患者（75.9%）。最终访视时，106例患者（79.7%）至少1眼BCVA为20/40或更好，保持驾驶标准视力，17例患者（12.8%）双眼BCVA为20/200或更差，法定失明。首次就诊时的平均BCVA与随访1年或5年时的平均BCVA差异无统计学意义（P值均为0.65），但显著优于随访10年时的平均BCVA （P = 0.04）。79%在第一次就诊时视力为20/40或更好的眼睛在10年的随访中保持了相同的视力水平。在第一次就诊时视力为20/200或更差的眼睛中，92%的眼睛在10年的随访中保持了相同的视力水平。囊样黄斑变性、脉络膜新生血管（CNV）、OCT视网膜外破坏和FAF变化与最后一次就诊时视力较差有关
Purpose: To evaluate the long-term visual outcomes and causes of vision loss in chronic central serous chorioretinopathy (CSC).Design: Retrospective, longitudinal study.Participants: A total of 133 participants (217 eyes) with chronic CSC.Methods: A retrospective review of clinical and multimodal imaging data of patients with chronic CSC managed by 3 of the authors between May 1977 and March 2018. Multimodal imaging comprised color photography, fluorescein angiography, indocyanine green angiography, fundus autofluorescence (FAF), and OCT.Main Outcome Measures: Best-corrected visual acuity (BCVA) at the final visit; change in BCVA between first visit and 1-, 5-, and 10-year follow-up visits; and causes of vision loss at final visit.Results: Data from 6228 individual clinic visits were analyzed. Mean age of patients at the first visit was 60.7 years, and mean period of follow-up from first to last visit was 11.3 years. The cohort included 101 male patients (75.9%). At the final visit, 106 patients (79.7%) maintained driving-standard vision with BCVA of 20/40 or better in at least 1 eye, and 17 patients (12.8%) were legally blind with BCVA of 20/200 or worse in both eyes. Mean BCVA at first visit was not significantly different from mean BCVA at 1-or 5-year follow-up visits (both P >= 0.65) but was significantly better than the mean BCVA at the 10-year follow-up visit (P = 0.04). Seventy-nine percent of eyes with 20/40 or better vision at the first visit maintained the same level of vision at the 10-year follow-up visit. Ninety-two percent of eyes with 20/200 or worse vision at the first visit maintained the same level of vision at the 10-year follow-up visit. Cystoid macular degeneration, choroidal neovascularization (CNV), outer retinal disruption on OCT, and FAF changes were associated with poorer vision at the final visit (all P