TY - JOUR
T1 - Bullous Variant of Central Serous Chorioretinopathy Expansion of Phenotypic Features Using Multimethod Imaging
AU - Balaratnasingam, Chandrakumar
AU - Freund, K. Bailey
AU - Tan, Anna M.
AU - Mrejen, Sarah
AU - Hunyor, Alex P.
AU - Keegan, David J.
AU - Dansingani, Kunal K.
AU - Dayani, Pouya N.
AU - Barbazetto, Irene A.
AU - Sarraf, David
AU - Jampol, Lee M.
AU - Yannuzzi, Lawrence A.
N1 - Funding Information:
Supported by the LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York; The Macula Foundation, Inc, New York, New York; and RANZCO Eye Foundation, NSW, Australia. The funding organizations had no role in the design or conduct of this research.
Publisher Copyright:
© 2016 American Academy of Ophthalmology.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Purpose To define the phenotypic characteristics of the bullous variant of central serous chorioretinopathy (CSC) using multimethod imaging. Design Retrospective, observational case series. Participants Twenty-one eyes of 14 patients with bullous retinal detachment resulting from CSC (bullous CSC group) and 122 eyes of 84 patients with chronic CSC without bullous retinal detachment (nonbullous CSC group). Methods We performed a retrospective review of clinical and multimethod imaging data of patients who sought treatment from the authors with bullous retinal detachment resulting from CSC between January 2010 and November 2015. Multimethod imaging comprised color photography, fluorescein angiography, fundus autofluorescence, and high-resolution optical coherence tomography. Consecutive cases of chronic CSC without bullous retinal detachment, seen during the same period, comprised a comparative group. Main Outcome Measures Qualitative and quantitative characteristics of the choroid, retinal pigment epithelium, and retina were compared between the 2 groups. Results Mean age of the bullous CSC group was 53.8 years. There was no difference in age, visual acuity, corticosteroid use, or the proportion of white patients and men between the 2 groups (all P > 0.132). Peripheral nonperfusion occurred only in eyes with bullous retinal detachment (38% of cases). Retinal pigment epithelial tears were seen in 95% of eyes in the bullous group and none of the eyes in the nonbullous CSC group. The bullous CSC group demonstrated a greater number of pigment epithelial detachments (PEDs) and more eyes demonstrated PEDs with internal hyperreflectivity (both P < 0.016). Mean subfoveal choroidal thickness in the bullous CSC group (463.1±83.1 μm) was not different compared with that of the nonbullous CSC group (400.6±100.6 μm; P = 0.993). More eyes in the bullous CSC group demonstrated hyperreflectivity around large choroidal vessels and at the level of the choriocapillaris on OCT (P < 0.001). Retinal folds and subretinal fibrin were identified in a greater proportion of eyes in the bullous CSC group (both P < 0.001). Conclusions Bullous retinal detachment is a rare manifestation of chronic CSC and is characterized by a unique constellation of phenotypic and multimethod imaging features.
AB - Purpose To define the phenotypic characteristics of the bullous variant of central serous chorioretinopathy (CSC) using multimethod imaging. Design Retrospective, observational case series. Participants Twenty-one eyes of 14 patients with bullous retinal detachment resulting from CSC (bullous CSC group) and 122 eyes of 84 patients with chronic CSC without bullous retinal detachment (nonbullous CSC group). Methods We performed a retrospective review of clinical and multimethod imaging data of patients who sought treatment from the authors with bullous retinal detachment resulting from CSC between January 2010 and November 2015. Multimethod imaging comprised color photography, fluorescein angiography, fundus autofluorescence, and high-resolution optical coherence tomography. Consecutive cases of chronic CSC without bullous retinal detachment, seen during the same period, comprised a comparative group. Main Outcome Measures Qualitative and quantitative characteristics of the choroid, retinal pigment epithelium, and retina were compared between the 2 groups. Results Mean age of the bullous CSC group was 53.8 years. There was no difference in age, visual acuity, corticosteroid use, or the proportion of white patients and men between the 2 groups (all P > 0.132). Peripheral nonperfusion occurred only in eyes with bullous retinal detachment (38% of cases). Retinal pigment epithelial tears were seen in 95% of eyes in the bullous group and none of the eyes in the nonbullous CSC group. The bullous CSC group demonstrated a greater number of pigment epithelial detachments (PEDs) and more eyes demonstrated PEDs with internal hyperreflectivity (both P < 0.016). Mean subfoveal choroidal thickness in the bullous CSC group (463.1±83.1 μm) was not different compared with that of the nonbullous CSC group (400.6±100.6 μm; P = 0.993). More eyes in the bullous CSC group demonstrated hyperreflectivity around large choroidal vessels and at the level of the choriocapillaris on OCT (P < 0.001). Retinal folds and subretinal fibrin were identified in a greater proportion of eyes in the bullous CSC group (both P < 0.001). Conclusions Bullous retinal detachment is a rare manifestation of chronic CSC and is characterized by a unique constellation of phenotypic and multimethod imaging features.
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U2 - 10.1016/j.ophtha.2016.03.017
DO - 10.1016/j.ophtha.2016.03.017
M3 - Article
C2 - 27084564
AN - SCOPUS:84964335714
VL - 123
SP - 1541
EP - 1552
JO - Ophthalmology
JF - Ophthalmology
SN - 0161-6420
IS - 7
ER -