Ellipsoid Zone Integrity at Angiographic Leak After Resolution of Central Serous Chorioretinopathy: MICRoN Report Number Two

Summary

ICSC with baseline perifoveal FFA leak: Longer symptom duration, complex disease, and irregular outer segment thickening associated with increased EZ atrophy at resolution — Micron Retrospective, 84 eyes.

Abstract

Purpose: This study aimed to explore prognostic factors for predicting ellipsoid zone integrity and its association with angiographic leakage and optical coherence tomography biomarkers at baseline.

Methods: In this multicenter retrospective study, resolved central serous chorioretinopathy (CSCR) eyes with perifoveal angiographic leak at baseline were included. Baseline demographics, clinical features, and anonymized imaging data, including fluorescein angiography, and optical coherence tomography were collected. The leakage site was identified on fluorescein angiography, and its corresponding location on optical coherence tomography was analyzed for structural changes and photoreceptor outer segment elongation. Central macular thickness, subfoveal choroidal thickness, Haller layer thickness, and Haller index (Haller layer thickness/subfoveal choroidal thickness) were measured at baseline and follow-up. Ellipsoid zone (EZ) integrity after resolution was classified as continuous, discontinuous, and atrophic.

Results: Eighty four eyes with resolved CSCR were included. Longer symptom duration ( P = 0.032) and complex CSCR ( P = 0.04) were associated with a higher likelihood of atrophic EZ. Significant reductions in central macular thickness, subfoveal choroidal thickness, and Haller layer thickness were observed in all groups, whereas the Haller index significantly reduced only in continuous EZ. Multinominal regression showed significant association between complex CSCR and atrophic EZ.

Conclusion: Longer symptom duration, complex CSCR, and irregular photoreceptor outer segment thickening are associated with increased risk of EZ atrophy in resolved CSCR. Identifying these risk factors early may help predict visual outcomes and guide patient counselling.