Staphyloma-induced serous maculopathy: natural course and treatment effects

Monica Ravenstijn; J P Martinez-Ciriano; G W de Graaf; C C W Klaver; S Yzer

doi:10.1016/j.oret.2023.11.008

Staphyloma-induced serous maculopathy: natural course and treatment effects

Monica Ravenstijn, J P Martinez-Ciriano, G W de Graaf, C C W Klaver, S Yzer

Research output: Contribution to journal › Article › Research › peer-review

Abstract

PURPOSE: To study the natural course of staphyloma induced serous maculopathy (SISM) and the effects of treatments.

DESIGN: Retrospective case-series PARTICIPANTS: This retrospective analysis included 26 eyes of 20 patients with SISM and at least 12 months of follow-up.

METHODS: Medical records were reviewed for patient demographics such as age, gender, spherical equivalent (SE), best-corrected visual acuity (BCVA), type of staphyloma and imaging characteristics. Spectralis OCT B-scans were evaluated for the presence and height of the serous retinal detachment (SRD) at each follow-up visit. An SRD episode was defined as a period with SRD in one patient.

MAIN OUTCOME MEASURES: Changes in SRD height and BCVA.

RESULTS: Twenty-six eyes of 20 patients (70% female) were included. Mean age was 54 ± 14 years and mean SE of -4.8 ± 3.3 Diopters at baseline. The staphyloma was located inferior in 12 eyes (46%), inferonasal in 7 eyes (27%) and nasal in 7 eyes (27%). Mean follow-up duration was 73 ± 34 months. During follow-up, the SRD height fluctuated in all eyes with a mean change of 125 ± 56 μm. The SRD disappeared completely during follow-up in 13 eyes (50%) and then reappeared in 7 eyes (35%). Resolution occurred spontaneous in 8 eyes (31%). The median time of an SRD episode was 25 (IQR 14 - 57) months. Treatment was performed in 20 eyes (76%) and led to resolution of SRD in 3 out of the 15 PDT treatments (21%), 2 out of 5 (40%) anti-VEGF series and 2 out of 4 eyes (50%) treated with topical prednisolone. BCVA at the final visit (0.42 ± 0.25) was not significantly different from BCVA at baseline (0.34 ± 0.27 LogMar, p = 0.07), nor was BCVA change significantly different between treated eyes (n=19) and non-treated eyes (n=7, p = 0.3).

CONCLUSION: SRD in SISM patients fluctuated over time and resolved without treatment in 31% of the eyes. Since treatment does not change the course of BCVA, a wait-and-see policy is advocated in these patients upon the exclusion of treatable causes of SRD.

Original language	English
Journal	Ophthalmology. Retina
DOIs	https://doi.org/10.1016/j.oret.2023.11.008
Publication status	E-pub ahead of print - 22 Nov 2023

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10.1016/j.oret.2023.11.008

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@article{571c893135044d0c98ec0193015a35c4,

title = "Staphyloma-induced serous maculopathy: natural course and treatment effects",

abstract = "PURPOSE: To study the natural course of staphyloma induced serous maculopathy (SISM) and the effects of treatments.DESIGN: Retrospective case-series PARTICIPANTS: This retrospective analysis included 26 eyes of 20 patients with SISM and at least 12 months of follow-up.METHODS: Medical records were reviewed for patient demographics such as age, gender, spherical equivalent (SE), best-corrected visual acuity (BCVA), type of staphyloma and imaging characteristics. Spectralis OCT B-scans were evaluated for the presence and height of the serous retinal detachment (SRD) at each follow-up visit. An SRD episode was defined as a period with SRD in one patient.MAIN OUTCOME MEASURES: Changes in SRD height and BCVA.RESULTS: Twenty-six eyes of 20 patients (70% female) were included. Mean age was 54 ± 14 years and mean SE of -4.8 ± 3.3 Diopters at baseline. The staphyloma was located inferior in 12 eyes (46%), inferonasal in 7 eyes (27%) and nasal in 7 eyes (27%). Mean follow-up duration was 73 ± 34 months. During follow-up, the SRD height fluctuated in all eyes with a mean change of 125 ± 56 μm. The SRD disappeared completely during follow-up in 13 eyes (50%) and then reappeared in 7 eyes (35%). Resolution occurred spontaneous in 8 eyes (31%). The median time of an SRD episode was 25 (IQR 14 - 57) months. Treatment was performed in 20 eyes (76%) and led to resolution of SRD in 3 out of the 15 PDT treatments (21%), 2 out of 5 (40%) anti-VEGF series and 2 out of 4 eyes (50%) treated with topical prednisolone. BCVA at the final visit (0.42 ± 0.25) was not significantly different from BCVA at baseline (0.34 ± 0.27 LogMar, p = 0.07), nor was BCVA change significantly different between treated eyes (n=19) and non-treated eyes (n=7, p = 0.3).CONCLUSION: SRD in SISM patients fluctuated over time and resolved without treatment in 31% of the eyes. Since treatment does not change the course of BCVA, a wait-and-see policy is advocated in these patients upon the exclusion of treatable causes of SRD.",

author = "Monica Ravenstijn and Martinez-Ciriano, {J P} and {de Graaf}, {G W} and Klaver, {C C W} and S Yzer",

note = "Copyright {\textcopyright} 2023. Published by Elsevier Inc.",

year = "2023",

month = nov,

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doi = "10.1016/j.oret.2023.11.008",

language = "English",

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TY - JOUR

T1 - Staphyloma-induced serous maculopathy

T2 - natural course and treatment effects

AU - Ravenstijn, Monica

AU - Martinez-Ciriano, J P

AU - de Graaf, G W

AU - Klaver, C C W

AU - Yzer, S

PY - 2023/11/22

Y1 - 2023/11/22

N2 - PURPOSE: To study the natural course of staphyloma induced serous maculopathy (SISM) and the effects of treatments.DESIGN: Retrospective case-series PARTICIPANTS: This retrospective analysis included 26 eyes of 20 patients with SISM and at least 12 months of follow-up.METHODS: Medical records were reviewed for patient demographics such as age, gender, spherical equivalent (SE), best-corrected visual acuity (BCVA), type of staphyloma and imaging characteristics. Spectralis OCT B-scans were evaluated for the presence and height of the serous retinal detachment (SRD) at each follow-up visit. An SRD episode was defined as a period with SRD in one patient.MAIN OUTCOME MEASURES: Changes in SRD height and BCVA.RESULTS: Twenty-six eyes of 20 patients (70% female) were included. Mean age was 54 ± 14 years and mean SE of -4.8 ± 3.3 Diopters at baseline. The staphyloma was located inferior in 12 eyes (46%), inferonasal in 7 eyes (27%) and nasal in 7 eyes (27%). Mean follow-up duration was 73 ± 34 months. During follow-up, the SRD height fluctuated in all eyes with a mean change of 125 ± 56 μm. The SRD disappeared completely during follow-up in 13 eyes (50%) and then reappeared in 7 eyes (35%). Resolution occurred spontaneous in 8 eyes (31%). The median time of an SRD episode was 25 (IQR 14 - 57) months. Treatment was performed in 20 eyes (76%) and led to resolution of SRD in 3 out of the 15 PDT treatments (21%), 2 out of 5 (40%) anti-VEGF series and 2 out of 4 eyes (50%) treated with topical prednisolone. BCVA at the final visit (0.42 ± 0.25) was not significantly different from BCVA at baseline (0.34 ± 0.27 LogMar, p = 0.07), nor was BCVA change significantly different between treated eyes (n=19) and non-treated eyes (n=7, p = 0.3).CONCLUSION: SRD in SISM patients fluctuated over time and resolved without treatment in 31% of the eyes. Since treatment does not change the course of BCVA, a wait-and-see policy is advocated in these patients upon the exclusion of treatable causes of SRD.

AB - PURPOSE: To study the natural course of staphyloma induced serous maculopathy (SISM) and the effects of treatments.DESIGN: Retrospective case-series PARTICIPANTS: This retrospective analysis included 26 eyes of 20 patients with SISM and at least 12 months of follow-up.METHODS: Medical records were reviewed for patient demographics such as age, gender, spherical equivalent (SE), best-corrected visual acuity (BCVA), type of staphyloma and imaging characteristics. Spectralis OCT B-scans were evaluated for the presence and height of the serous retinal detachment (SRD) at each follow-up visit. An SRD episode was defined as a period with SRD in one patient.MAIN OUTCOME MEASURES: Changes in SRD height and BCVA.RESULTS: Twenty-six eyes of 20 patients (70% female) were included. Mean age was 54 ± 14 years and mean SE of -4.8 ± 3.3 Diopters at baseline. The staphyloma was located inferior in 12 eyes (46%), inferonasal in 7 eyes (27%) and nasal in 7 eyes (27%). Mean follow-up duration was 73 ± 34 months. During follow-up, the SRD height fluctuated in all eyes with a mean change of 125 ± 56 μm. The SRD disappeared completely during follow-up in 13 eyes (50%) and then reappeared in 7 eyes (35%). Resolution occurred spontaneous in 8 eyes (31%). The median time of an SRD episode was 25 (IQR 14 - 57) months. Treatment was performed in 20 eyes (76%) and led to resolution of SRD in 3 out of the 15 PDT treatments (21%), 2 out of 5 (40%) anti-VEGF series and 2 out of 4 eyes (50%) treated with topical prednisolone. BCVA at the final visit (0.42 ± 0.25) was not significantly different from BCVA at baseline (0.34 ± 0.27 LogMar, p = 0.07), nor was BCVA change significantly different between treated eyes (n=19) and non-treated eyes (n=7, p = 0.3).CONCLUSION: SRD in SISM patients fluctuated over time and resolved without treatment in 31% of the eyes. Since treatment does not change the course of BCVA, a wait-and-see policy is advocated in these patients upon the exclusion of treatable causes of SRD.

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DO - 10.1016/j.oret.2023.11.008

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SN - 2468-7219

JO - Ophthalmology. Retina

JF - Ophthalmology. Retina

ER -

Staphyloma-induced serous maculopathy: natural course and treatment effects

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