Imaging Characteristics and Longitudinal Follow-Up of Inner Choroidal Fibrosis in Chronic Central Serous Chorioretinopathy.

Abstract

To study imaging characteristics of inner choroidal fibrosis (ICF) in eyes with chronic central serous chorioretinopathy (CSC) and report long term changes. Retrospective interventional case series. Records of chronic CSC patients between January 2004 and September 2024 were reviewed to identify and study longitudinal changes in eyes with ICF. ICF was divided into morphological types: type 1 and type 2. Type 1 ICF represented disorganized inner choroid without well-defined accumulations, while type 2 ICF represented accumulations with a demarcation line. Thirty-eight eyes of 23 patients were identified. All the eyes had complex CSC, with a mean of 1.7 lesions per eye. Patients were followed up for a median period of 36.5 months. The mean BCVA reduced from 0.67 ± 0.46 logMAR (20/95) to 0.78 ± 0.44 logMAR (20/121). Mean BCVA at time of presentation (0.83 logMAR, 20/135 vs 0.51 logMAR, 20/65; P = .1), as well as at last visit (0.88 logMAR, 20/152 vs 0.66 logMAR, 20/91; P = .7) was worse in eyes with Type 2 as compared to Type 1 ICF. Resolution of CSC was seen in 5 eyes (12.8%) at the last visit. There was a non-significant decrease in SFCT (456 vs 444 microns, P = .8) and significant increase in hypo-fluorescence area on indocyanine green angiography of 4.25 sq. mm (P < .00001). Higher duration of follow-up and persistent fluid were associated with increase of size in ICF on multivariate regression analysis. ICF in complex CSC was associated with persistent fluid and poor response to therapy. It was seen to increase in size with increasing chronicity.