Staphyloma-induced serous maculopathy: natural course and treatment effects

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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.

Originele taal-2Engels
TijdschriftOphthalmology. Retina
StatusE-publicatie vóór gedrukte publicatie - 22 nov. 2023


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