PREVALENCE AND MORPHOLOGIC BIOMARKERS OF METAMORPHOPSIA IN EYES WITH “RESOLVED” CHRONIC CENTRAL SEROUS CHORIORETINOPATHY

Abstract

Purpose: To assess relationships between demographics, clinical characteristics, and optical coherence tomography characteristics with persistence of metamorphopsia after resolution of subretinal fluid in eyes with chronic central serous chorioretinopathy. Methods: One-hundred participants with “resolved” (absence of subretinal fluid) chronic central serous chorioretinopathy were retrospectively analyzed. Patients underwent a complete ophthalmologic evaluation, including assessment of the presence of metamorphopsia. At the study visit, optical coherence tomography scans were reviewed for qualitative and quantitative features. Results: Sixty-six of 100 patients (66.0%) complained of metamorphopsia. Both the foveal and parafoveal ganglion cell complex thicknesses were thinner in central serous chorioretinopathy eyes with metamorphopsia (35.1 ± 10.6 µm and 82.0 ± 18.1 µm vs. 40.7 ± 11.8 µm and 93.1 ± 13.5 µm, P = 0.030 and P < 0.0001). In the foveal region, the outer plexiform layer and outer nuclear layer thicknesses were thinner in patients with metamorphopsia (24.6 ± 8.5 µm and 63.1 ± 20.9 µm vs. 29.1 ± 8.7 and 76.2 ± 18.2 µm, P = 0.016 and P = 0.005). The ellipsoid zone band was more frequently discontinued in eyes with metamorphopsia (56.1% vs. 35.3%, P = 0.039). Multivariate stepwise linear regression analysis demonstrated that the strongest associations with the presence of metamorphopsia were with parafoveal ganglion cell complex thickness (P = 0.004), foveal outer nuclear layer thickness (P = 0.010), and number of previous recurrences of subretinal fluid accumulation (P = 0.017). The time interval from the last subretinal fluid resolution was not associated with the presence of metamorphopsia. Conclusion: In “resolved” central serous chorioretinopathy, clinical aspects (i.e., number of previous recurrences) and structural changes (i.e., ganglion cell complex and outer nuclear layer thinning) are associated with metamorphopsia after subretinal fluid resolution.