Funduscopy-guided fluorescein angiography-free focal laser photocoagulation for central serous chorioretinopathy

• Published in: Indian journal of ophthalmology Vol. 70; no. 3; pp. 890 - 894
• Main Authors: Mohanty, Anuja, Mahapatra, Santosh
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01-03-2022; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Angiography; Care and treatment; central serous chorioretinopathy; Central Serous Chorioretinopathy - diagnosis; Central Serous Chorioretinopathy - surgery; Eye; Fluorescein; Fluorescein Angiography - methods; fluorescein angiography-free; focal laser photocoagulation; Humans; hypopigmented spot; Laser coagulation; Lasers; Leakage; Light Coagulation; Medical imaging; Methods; Ophthalmoscope and ophthalmoscopy; Patients; pigment epithelial detachment; Retinal diseases; Retrospective Studies; Special Focus, Retina, Original; Tomography, Optical Coherence - methods; India; fluorescein angiography-free; hypopigmented spot; pigment epithelial detachment; Central serous chorioretinopathy; focal laser photocoagulation
• ISSN: 0301-4738; 1998-3689
• DOI: 10.4103/ijo.IJO_2006_21

Purpose: To identify and correlate hypopigmented spots on fundoscopy with the leakage points on fluorescein angiography (FA) in patients with central serous chorioretinopathy (CSCR) to provide criteria for FA-free focal laser photocoagulation (FLP). Methods: Fifty consecutive patients of acute CSCR were evaluated between March and October 2019 confirming the inclusion and exclusion criteria. Colocalization of leakage points with discrete hypopigmented spots on clinical fundoscopy was evaluated using FA. Positive predictive value (PPV) was calculated to identify the status of association between these to formulate criteria for FA-free FLP of CSCR patients in future. Results: Out of the 50 eyes, 38 (76%) had a discrete hypopigmented spot on fundoscopy which coincided with the leakage point on FA. The PPV of finding a leakage point at the area of discrete hypopigmented spot is 95%. Colocalization with a pigment epithelial detachment was found in 25 (65.7%) of these 38 eyes. Retinal pigment epithelial irregularities were found associated in all of these 38 eyes. Subretinal homogenously hyperreflective material was found in 8 (21.05%) of 38 eyes. optical coherence tomography following FLP of leakage point in all cases showed complete resolution of CSCR in 47 (94%) eyes. Conclusion: This study demonstrates that hypopigmented spots on clinical fundus examination in CSCR patients, when present, coincide with the leakage point of FA. This may aid to undergo FA-free FLP treatment in CSCR patients.