Subretinal Fluid Duration and Clinical Outcomes in Central Serous Chorioretinopathy: An Analysis of Time-to-Photodynamic Therapy

Summary

Prolonged SRF exposure beyond 1-2 months in ICSC is associated with increased ONL thinning. Retrospective, 94 eyes.

Abstract

Objective: To estimate the effect of prolonged serous retinal detachment (SRD) during the waiting period for photodynamic therapy (PDT) on clinical outcomes in patients with central serous chorioretinopathy (CSC).

Design: Retrospective case series.

Subjects: Consecutive patients with CSC who underwent PDT between January 2016 and August 2024. Patients whose SRD resolved spontaneously while awaiting PDT were excluded.

Methods: We measured the best-corrected visual acuity (BCVA) and retinal layer thickness at baseline and on the day of PDT. We evaluated (1) the changes in these parameters during the waiting period and (2) the association between the duration of this period and the outcomes.

Main outcome measures: Associations of the time-to-PDT with 12-month BCVA, SRD remission at 12 months, and changes in retinal layer thickness during the waiting period.

Results: Ninety-four patients (94 eyes) with CSC were included, with a mean age of 57.6 ± 12.2 years, a mean BCVA of 0.18 ± 0.24 logMAR (Snellen: 20/30), and a mean waiting period of 50.8 ± 50.2 days. The outer nuclear layer thinned significantly during the waiting period (mean reduction = 1.9 ± 4.4 μm, P = 3.4 × 10^-5), and longer waiting times were associated with greater thinning (crude: β = -0.04, P = 3.5 × 10^-6; adjusted: β = -0.04, P = 1.3 × 10^-6). However, waiting duration was not significantly associated with 12-month treatment outcomes.

Conclusions: Our findings suggest that caution is warranted against prolonged subretinal fluid exposure beyond 1 to 2 months, as it may induce outer nuclear layer thinning.