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Published on: January 21, 2018
Imaging Characteristics and Longitudinal Follow-Up of Inner Choroidal Fibrosis in Chronic Central Serous
Saarang Hansraj1, Jay Chhablani2, Raja Narayanan1
1From the Kallam Anji Reddy Campus (S.H., R.N.), L V Prasad Eye Institute, Anant Bajaj Retina Institute, Hyderabad, India.
Purpose:
To study imaging characteristics of inner choroidal fibrosis (ICF) in eyes with chronic central serous chorioretinopathy (CSC) and report long term changes.
Design:
Retrospective interventional case series.
Methods:
Records of chronic CSC patients between January 2004 and September 2024 were reviewed to identify and study longitudinal changes in eyes with ICF. ICF was divided into morphological types: type 1 and type 2. Type 1 ICF represented disorganized inner choroid without well-defined accumulations, while type 2 ICF represented accumulations with a demarcation line.
Results:
Thirty-eight eyes of 23 patients were identified. All the eyes had complex CSC, with a mean of 1.7 lesions per eye. Patients were followed up for a median period of 36.5 months. The mean BCVA reduced from 0.67 ± 0.46 logMAR (20/95) to 0.78 ± 0.44 logMAR (20/121). Mean BCVA at time of presentation (0.83 logMAR, 20/135 vs 0.51 logMAR, 20/65; P = .1), as well as at last visit (0.88 logMAR, 20/152 vs 0.66 logMAR, 20/91; P = .7) was worse in eyes with Type 2 as compared to Type 1 ICF. Resolution of CSC was seen in 5 eyes (12.8%) at the last visit. There was a non-significant decrease in SFCT (456 vs 444 microns, P = .8) and significant increase in hypo-fluorescence area on indocyanine green angiography of 4.25 sq. mm (P < .00001). Higher duration of follow-up and persistent fluid were associated with increase of size in ICF on multivariate regression analysis.
Conclusion:
ICF in complex CSC was associated with persistent fluid and poor response to therapy. It was seen to increase in size with increasing chronicity.
