Characteristics and treatment responses of cystoid retina associated with central serous chorioretinopathy

Abstract

Purpose

To detect the characteristics of cystoid retina associated with central serous chorioretinopathy (CSC) using multimodal imaging and to evaluate anatomical and functional responses for treatment.

Study design

A retrospective case series

Method

This retrospective study included 21 eyes of 17 patients with the treatment for combined cystoid retinal changes and submacular fluid associated with CSC. Multimodal imaging analysis including cross-sectional OCT, en face OCT, fluorescein and indocyanine green angiography, and fundus autofluorescence were performed to assess the characteristics of cystoid changes. In 21 eyes of 17 patients, clinical courses after treatment were reviewed.

Results

Fourteen of 17 patients were men (82.4%), and the mean age was 63.2. Fluorescein angiography revealed one or more focal leakages in all eyes, and intense leakage, due to peripapillary atrophy and from areas showing retinal pigment epithelial atrophy, was observed in 11 eyes and 12 eyes respectively. En face OCT visualized cystoid retinal changes as honey-comb like areas, and this was observed in the papillomacular region in 16 eyes (76.2%). After reduced-fluence photodynamic therapy (PDT), combination of anti-VEGF and PDT, or photocoagulation, subretinal fluid resolved in 20 eyes (95.2%), and complete resolution of cystoid retinal changes was obtained in 13 eyes (61.9%).

Conclusion

Cystoid retinal changes can be associated with patchy retinal pigment epithelial atrophy and with peripapillary atrophy in CSC eyes. Laser treatment is beneficial for resolving cystoid retina as well as subretinal fluid.

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Acknowledgments

This manuscript was partly supported by the Grants-in-Aids for Scientific Research. Fumi Gomi obtained a research grant from Novartis. We thank Jane Charbonneau, DVM, from Edanz Group (https://en-author-services.edanzgroup.com/ac) for editing a draft of this manuscript.

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Correspondence to Fumi Gomi.

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H. Fukuyama, None; Y. Komuku, None; F. Gomi, Grant (Pfizer, Alcon, Novartis, Otsuka), Lecture fee (Santen, Senju, GlaxoSmithKline), Speaker fee (Bayer).

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Corresponding Author: Fumi Gomi

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Fukuyama, H., Komuku, Y. & Gomi, F. Characteristics and treatment responses of cystoid retina associated with central serous chorioretinopathy. Jpn J Ophthalmol (2021). https://doi.org/10.1007/s10384-021-00815-x

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Keywords

  • Photodynamic therapy
  • En face
  • Optical coherence tomography
  • Central serous chorioretinopathy
  • Cystoid retinal changes