Central serous chorioretinopathy and vitelliform dystrophies occurring in adults: predictors of differential diagnosis
- Authors: Matcko N.V.1,2, Gatsu M.V.1,2
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Affiliations:
- S.N. Fedorov National Medical Research Center “MNTK “Eye Microsurgery”
- I.I. Mechnikov North-Western State Medical University
- Issue: Vol 14, No 1 (2021)
- Pages: 51-61
- Section: Original researches
- URL: https://journals.eco-vector.com/ov/article/view/64310
- DOI: https://doi.org/10.17816/OV64310
- ID: 64310
Cite item
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
PhD Student
Russian Federation, 41 Kirochnaya str., Saint Petersburg, 191015; Saint PetersburgMarina 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
Dr. Sci. (Med.), professor
Russian Federation, 41 Kirochnaya str., Saint Petersburg, 191015; Saint PetersburgReferences
- Spaide RF. Deposition of yellow submacular material in central serous chorioretinopathy resembling adult-onset foveomacular vitelliform dystrophy. Retina. 2004;24(2):301–304. doi: 10.1097/00006982-200404000-00019
- Lee Y, Kim E, Kim M, et al. Atypical vitelliform macular dystrophy misdiagnosed as chronic central serous chorioretinopathy: case reports. BMC Ophthalmol. 2012;12(1):25. doi: 10.1186/1471-2415-12-25
- Lin CF, Sarraf D. Best disease presenting as a giant serous pigment epithelial detachment. Retin Cases Brief Rep. 2014;8(4): 247–250. doi: 10.1097/ICB.0000000000000101.
- Alfonso-Muñoz EA, Dolz-Marco R. Bestrophinopathy Mimicking Central Serous Chorioretinopathy. Ophthalmol Retina. 2018;2(8):857. doi: 10.1016/j.oret.2018.04.021.
- Zatreanu L, Freund KB, Leong BCS, еt al. Serous macular detachment in best disease: A masquerade syndrome. Retina. 2019;40(8):1456–1470. doi: 10.1097/iae.0000000000002659
- Sadda S, Guymer R, Holz F, et al. Consensus Definition for Atrophy Associated with Age-Related Macular Degeneration on OCT. Ophthalmol. 2018;125(4):537–548. doi: 10.1016/j.ophtha.2017.09.028
- Klepinina OB. Subporogovoe mikroimpul’snoe lazernoe vozdejstvie dlinoj volny 577 nm pri lechenii central’noj seroznoj horioretinopatii [dissertation]. Moscow, 2014. (In Russ.)
- Gonta A. Harakteristiki izobrazhenija: kontrast, dinamicheskij diapazon, rezkost’. Algoritm Bezopasnosti magazine. 2006;(5):56–60. (In Russ.)
- Coscas F, Puche N, Coscas G, et al. Comparison of Macular Choroidal Thickness in Adult Onset Foveomacular Vitelliform Dystrophy and Age-Related Macular Degeneration. Investig Opthalmol Vis Sci. 2014;55(1):64. doi: 10.1167/iovs.13-12931
- Dansingani K, Balaratnasingam C, Klufas M, et al. Optical Coherence Tomography Angiography of Shallow Irregular Pigment Epithelial Detachments In Pachychoroid Spectrum Disease. Am J Ophthalmol. 2015;160(6):1243–1254.e2. doi: 10.1016/j.ajo.2015.08.028
- Pedanova EK, Klepinina OB, Buryakov DA. Accordance of Indocyanine Green Angiography and Optical Coherence Tomography Angiography in Visualization of Neovascularization Associated with Chronic Central Serous Chorioretinopathy. Ophthalmology in Russia. 2018;15(2S):254–260. (In Russ.) DOI: org/10.18008/1816-5095-2018-2S-254-260