Chronic central serous chorioretinopathy: long-term follow-up and vision-related quality of life

Abstract

Purpose

To describe the clinical findings and long-term outcome of patients with chronic central serous chorioretinopathy (cCSC).

Materials and methods

This was a retrospective case series in 52 eyes of 36 patients with a follow-up period of at least 1 year. Extensive ophthalmic examination and a validated questionnaire concerning vision-related quality of life (National Eye Institute Visual Function Questionnaire [NEI-VFQ]-39) were analyzed.

Results

Mean visual acuity showed a significant decline over time of 0.16 logarithm of minimum angle of resolution ([logMAR] range: −0.22 to 1.3; P=0.009) after a mean follow-up period of 10.6 years. Also, patients reported lower vision-related quality of life based on the NEI-VFQ-39 for almost all categories compared to healthy controls. Macular atrophy was diagnosed more often on optical coherence tomography compared to other diagnostic entities. Retinal pigment epithelium detachments in the macula were documented on optical coherence tomography in 56% of the patients. A significant thinning of foveal thickness was measured over time compared to unaffected fellow eyes (P=0.002). On long-term follow-up, 13 eyes (37%) showed an increase in number of hot spots on fluorescein angiography.

Conclusion

This study indicates that cCSC is a progressive disease in many patients, causing a progressive decline in visual acuity, accompanied by lower reported vision-related quality of life. In deciding whether or not to treat, the progressive nature of cCSC should be taken into account in this relatively young and often still professionally active patient group.

Keywords:

• chronic central serous chorioretinopathy
• micropulse laser
• NEI-VFQ-39
• PDT
• vision-related quality of life

Acknowledgments

The authors thank Joannes MM Groenewoud (PhD) for his statistical support and input to this manuscript. This study was supported by the Macula Vision Research Foundation, MD Fonds, Landelijke Stichting voor Blinden en Slechtzienden, Gelderse Blindenstichting, Stichting Nederlands Oogheelkundig Onderzoek, Stichting Blindenhulp, Stichting AF Deutman Oogheelkunde Researchfonds, Nijmeegse Oogonderzoek Stichting, Janivo Stichting, and Oogfonds. The sponsor or funding organization had no role in the design or conduct of this research. Dr Camiel JF Boon is now employed by the Department of Ophthalmology, Acedemic Medical Center Amsterdam.

Disclosure

Dr Camiel JF Boon was supported by a Niels Stensen Fellowship. The authors report no conflicts of interest in this work.