Сentral serous chorioretinopathy and vitelliform dystrophies occurring in adults: predictors of differential diagnosis

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Abstract


AIM: To study predictors in order to optimize the differential diagnosis of persistent central serous chorioretinopathy (CSCR) and different forms of vitelliform dystrophies occurring in adults.

MATERIALS AND METHODS: Ninety eyes of 61 patients with long-term serous retinal detachments were recruited in study. All patients underwent ophthalmologic examination including family history, best corrected visual acuity, biomicroscopy, and multimodal imaging including fundus photo, SD-OCT, OCT-A, BAF, FA, ICGA. After the studies, the patients were divided into two groups: with vitelliform dystrophies – 30 eyes of 30 patients and with CSCR – 31 eyes of 31 patients. Diagnostic predictors found in both groups were scrutinized, mathematical models were obtained, and their recognition quality was assessed by the area under ROC curve. The criteria for all types of research were studied and the predictive value was assessed with the use of ROC analysis.

RESULTS: The most informative non-invasive predictors for the diagnosis of vitelliform dystrophies occurring in adults are the following: a positive family history of the disease, brightness and gradient of hyperautofluorescence (hyperAF), typical hyperAF in the form of a “crescent” and “beads”, the presence of massive subretinal deposits and deposits in the form of “stalactites”. The most informative non-invasive predictors for the diagnosis of persistent CSCR are the following: additional hypoAF or hyperAF points or areas outside the main focus, hyperreflective dots in the neurosensory retina and an increase in choroidal thickness, irregular pigment epithelial detachments, presence of CNV. The highest predictive value for both groups was determined for BAF studies.

CONCLUSIONS: The results obtained make it possible to optimize the differential diagnosis of persistent CSCR and different forms of vitelliform dystrophies occurring in adults.


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About the authors

Nataliia V. Matcko

S.N. Fedorov National Medical Research Center “MNTK “Eye Microsurgery”; I.I. Mechnikov North-Western State Medical University

Author for correspondence.
Email: matsko.natalia@mail.ru
ORCID iD: 0000-0001-8909-9999
SPIN-code: 9790-4066

Russian Federation, 41 Kirochnaya str., Saint Petersburg, 191015; Saint Petersburg

PhD Student

Marina V. Gatsu

S.N. Fedorov National Medical Research Center “MNTK “Eye Microsurgery”; I.I. Mechnikov North-Western State Medical University

Email: m-gatsu@yandex.ru
ORCID iD: 0000-0002-9357-5801

Russian Federation, 41 Kirochnaya str., Saint Petersburg, 191015; Saint Petersburg

Dr. Sci. (Med.), professor

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Supplementary files

Supplementary Files Action
1.
Fig. 1. Grayscale

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2.
Fig. 2. Blue light versus green light fundus autofluorescence in patients with persistent central serous chorioretinopathy and vitelliform dystrophies occurring in adults. 1, 2, 3, 4 – brightness of hyperautofluorescence (hyperAF) defined by Grayscale

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3.
Fig. 3. Spectral domain optical coherence tomography (SD-OCT) (a–d) and optical coherence tomography angiography (OCT-A) (e–h) of patients: a, e – with autosomal recessive bestrofinopathy; b, f – with Best macular dystrophy; c, g, d, h – with persistent central serous chorioretinopathy

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4.
Fig. 4. Illustration of the most significant predictors of BAF in groups with persistent central serous chorioretinopathy (a, b) and vitelliform dystrophies occurring in adults (c, d)

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5.
Fig. 5. Illustration of the most significant predictors of ICG in groups with persistent central serous chorioretinopathy and vitelliform dystrophies occurring in adults

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Copyright (c) 2021 Matcko N.V., Gatsu M.V.

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