Central Serous Chorioretinopathy in Elderly Patients Mimicking Occult Neovascular Age-Related Macular Degeneration

Sean D Adrean,1 Siyang Chaili,2 Ash Pirouz,1 Scott Grant1 1Retina Consultants of Orange County, Fullerton, CA 92835, USA; 2Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN 37232, USACorrespondence: Sean D AdreanRetina Consultants of Orange County, 301 W. Bastanchury Ave...

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Autores principales:	Adrean SD, Chaili S, Pirouz A, Grant S
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	central serous chorioretinopathy elderly choroidal neovascular membranes choroid Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/ede8ab911d8e4e32a394e6c49202ea43
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spelling	oai:doaj.org-article:ede8ab911d8e4e32a394e6c49202ea432021-12-02T11:21:38ZCentral Serous Chorioretinopathy in Elderly Patients Mimicking Occult Neovascular Age-Related Macular Degeneration1177-5483https://doaj.org/article/ede8ab911d8e4e32a394e6c49202ea432020-11-01T00:00:00Zhttps://www.dovepress.com/central-serous-chorioretinopathy-in-elderly-patients-mimicking-occult--peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Sean D Adrean,1 Siyang Chaili,2 Ash Pirouz,1 Scott Grant1 1Retina Consultants of Orange County, Fullerton, CA 92835, USA; 2Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN 37232, USACorrespondence: Sean D AdreanRetina Consultants of Orange County, 301 W. Bastanchury Ave #285, Fullerton, CA 92835, USATel +1-714-738-4620Email seadrean@yahoo.comPurpose: To describe elderly patients with central serous chorioretinopathy (CSCR) mimicking occult neovascular age-related macular degeneration (nAMD).Materials and Methods: The records of 522 patients with initial diagnoses of nAMD over one year were reviewed to determine characteristics meeting diagnostic criteria for CSCR with three or more months of follow-up. Patients were evaluated by clinical examination, fluorescein angiography (FA) and optical coherence tomography (OCT). At the time of initial evaluation, patients were either monitored, treated with anti-VEGF therapy or with combination anti-VEGF and photodynamic therapy (PDT). When no response to anti-vascular endothelial growth factor (anti-VEGF) treatment was observed, the diagnosis of CSCR was favored and patients were observed with close follow-up. The Student’s t-test was used for statistical analysis; a p-value < 0.05 was considered statistically significant.Results: Eleven elderly patients met diagnostic criteria for CSCR among 522 patients initially diagnosed with nAMD. Average age was 75.9 years, and average follow-up was 16.9 months. Average presenting visual acuity was 20/50+2 (67.9 ± 5.9 ETDRS letters), and choroidal thickness was 232.0 ± 69.4 μm. After observation or treatment, the average vision improved to 20/40+ (70.5 ± 7.8 ETDRS letters, p=0.289). When intravitreal bevacizumab was given, no changes were observed for patients’ neurosensory retinal detachments (NSRD). When NSRD changes were observed, they likewise did not correlate to the timing of anti-VEGF treatment. For patients who were monitored alone, one patient lost one line of vision, one gained one line, one gained two lines, and one gained three lines. One patient subsequently developed a choroidal neovascular membrane (CNVM) during initial follow-up with visual improvement after anti-VEGF treatment. Four patients developed CNVM overall with long term follow-up.Conclusion: CSCR in elderly patients can mimic occult CNVM, especially on FA. In this group, many patients were monitored without treatment, which typically resulted in stable or improved vision. Careful monitoring is required because of possible development of CNVM.Keywords: central serous chorioretinopathy, elderly, choroidal neovascular membranes, choroidAdrean SDChaili SPirouz AGrant SDove Medical Pressarticlecentral serous chorioretinopathyelderlychoroidal neovascular membraneschoroidOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 4073-4078 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	central serous chorioretinopathy elderly choroidal neovascular membranes choroid Ophthalmology RE1-994
spellingShingle	central serous chorioretinopathy elderly choroidal neovascular membranes choroid Ophthalmology RE1-994 Adrean SD Chaili S Pirouz A Grant S Central Serous Chorioretinopathy in Elderly Patients Mimicking Occult Neovascular Age-Related Macular Degeneration
description	Sean D Adrean,1 Siyang Chaili,2 Ash Pirouz,1 Scott Grant1 1Retina Consultants of Orange County, Fullerton, CA 92835, USA; 2Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN 37232, USACorrespondence: Sean D AdreanRetina Consultants of Orange County, 301 W. Bastanchury Ave #285, Fullerton, CA 92835, USATel +1-714-738-4620Email seadrean@yahoo.comPurpose: To describe elderly patients with central serous chorioretinopathy (CSCR) mimicking occult neovascular age-related macular degeneration (nAMD).Materials and Methods: The records of 522 patients with initial diagnoses of nAMD over one year were reviewed to determine characteristics meeting diagnostic criteria for CSCR with three or more months of follow-up. Patients were evaluated by clinical examination, fluorescein angiography (FA) and optical coherence tomography (OCT). At the time of initial evaluation, patients were either monitored, treated with anti-VEGF therapy or with combination anti-VEGF and photodynamic therapy (PDT). When no response to anti-vascular endothelial growth factor (anti-VEGF) treatment was observed, the diagnosis of CSCR was favored and patients were observed with close follow-up. The Student’s t-test was used for statistical analysis; a p-value < 0.05 was considered statistically significant.Results: Eleven elderly patients met diagnostic criteria for CSCR among 522 patients initially diagnosed with nAMD. Average age was 75.9 years, and average follow-up was 16.9 months. Average presenting visual acuity was 20/50+2 (67.9 ± 5.9 ETDRS letters), and choroidal thickness was 232.0 ± 69.4 μm. After observation or treatment, the average vision improved to 20/40+ (70.5 ± 7.8 ETDRS letters, p=0.289). When intravitreal bevacizumab was given, no changes were observed for patients’ neurosensory retinal detachments (NSRD). When NSRD changes were observed, they likewise did not correlate to the timing of anti-VEGF treatment. For patients who were monitored alone, one patient lost one line of vision, one gained one line, one gained two lines, and one gained three lines. One patient subsequently developed a choroidal neovascular membrane (CNVM) during initial follow-up with visual improvement after anti-VEGF treatment. Four patients developed CNVM overall with long term follow-up.Conclusion: CSCR in elderly patients can mimic occult CNVM, especially on FA. In this group, many patients were monitored without treatment, which typically resulted in stable or improved vision. Careful monitoring is required because of possible development of CNVM.Keywords: central serous chorioretinopathy, elderly, choroidal neovascular membranes, choroid
format	article
author	Adrean SD Chaili S Pirouz A Grant S
author_facet	Adrean SD Chaili S Pirouz A Grant S
author_sort	Adrean SD
title	Central Serous Chorioretinopathy in Elderly Patients Mimicking Occult Neovascular Age-Related Macular Degeneration
title_short	Central Serous Chorioretinopathy in Elderly Patients Mimicking Occult Neovascular Age-Related Macular Degeneration
title_full	Central Serous Chorioretinopathy in Elderly Patients Mimicking Occult Neovascular Age-Related Macular Degeneration
title_fullStr	Central Serous Chorioretinopathy in Elderly Patients Mimicking Occult Neovascular Age-Related Macular Degeneration
title_full_unstemmed	Central Serous Chorioretinopathy in Elderly Patients Mimicking Occult Neovascular Age-Related Macular Degeneration
title_sort	central serous chorioretinopathy in elderly patients mimicking occult neovascular age-related macular degeneration
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/ede8ab911d8e4e32a394e6c49202ea43
work_keys_str_mv	AT adreansd centralserouschorioretinopathyinelderlypatientsmimickingoccultneovascularagerelatedmaculardegeneration AT chailis centralserouschorioretinopathyinelderlypatientsmimickingoccultneovascularagerelatedmaculardegeneration AT pirouza centralserouschorioretinopathyinelderlypatientsmimickingoccultneovascularagerelatedmaculardegeneration AT grants centralserouschorioretinopathyinelderlypatientsmimickingoccultneovascularagerelatedmaculardegeneration
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Central Serous Chorioretinopathy in Elderly Patients Mimicking Occult Neovascular Age-Related Macular Degeneration

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