Author: Dmitrii Maltsev (Russian Federation)
Co-authors: Alexei Kulikov, Maria Burnasheva, Jay Chhablani
Purpose
To study the potential of dark-field scanning laser ophthalmoscopy (DF-SLO) for the prognostication of non-chronic central serous chorioretinopathy (CSC).
Setting/Venue
Prospective single-center cohort study.
Methods
Fifty-two eyes of 52 patients (44 males and 8 females, mean age of 45.4 ± 8.8 years) with acute CSC were included in this prospective cohort study. At baseline, all patients received multimodal imaging including DF-SLO and then were observed until resolution of subretinal fluid or, in non-resolving cases, treated with laser therapy. At the end of the follow-up, each case was categorized as either, self-resolving, resolving after laser treatment, or non-resolving after laser treatment. Presence of granular retinal pigment epithelium (RPE) pattern and the lucency of RPE/choroid complex at the leak on DF-SLO images were used by the masked grader to identify non-resolving after laser treatment CSC cases.
Results
Using baseline DF-SLO images, the masked grader correctly classified 45 of 52 (86.5%) CSC cases as being self-resolving (demonstrated no changes on DF-SLO), resolving after laser treatment (demonstrated only RPE granular pattern), or non-resolving after laser treatment (demonstrated RPE/choroid complex lucency). Among cases which resolved and those non-resolved after laser treatment, the grader correctly classified 33 of 36 (91.4%) of cases.The area under the ROC, sensitivity, and specificity of DF-SLO used by the masked grader to identify cases which are non-resolving after laser treatment were 0.92 (confidential interval (CI) 0.79 to 0.98), 86.7% (CI 59.5% to 98.3%), and 96.6% (CI 82.2% to 99.2%), respectively.
Conlusions
DF-SLO at baseline may be a useful technique in prediction of self-resolution and response to laser treatment in acute CSC. Self-resolving cases typically demonstrate no changes with DF-SLO, while cases requiring laser treatment usually show granular RPE changes with or without the lucency at the leak. The presence of the lucency and the large area of granular RPE changes may indicate a higher risk of laser treatment failure.
Financial Disclosure
The authors have no proprietary or financial interest in any aspect of this report.
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