The Association Between Visual Function And Retinal Structure In Central Serous Chorioretinopathy

Objective: To investigate the association between visual function and retinal structure in central serous chorioretinopathy(CSC or CSCR)with different courses of disease and different locations of leakage points using optical coherence tomography(OCT)and MP-3 microperimetry.Methods:Cross-sectional cases study.In 34 eyes of 34 CSC patients with serous retinal detachment at the macula,retinal sensitivity was measured using MP-3 microperimetry.Foveal sensitivity(MS0),mean sensitivity within four degrees(MS4)and twenty degrees(MS20),as well as mean sensitivity of leakage point within four degrees(MSLP),were calculated.Retinal structure was measured using OCT.Not only the relationship between visual function(Log MAR best-corrected visual acuity[Log MAR VA] and MS0,MS4,MS20,MSLP)and retinal structure[serous retinal detachment height(SRDH)at the fovea and leakage point,central retinal thickness(CRT),the area of subretinal fluid(SRF)and central choroidal thickness(CCT)] but also the effects of different disease courses and different locations of leakage points on visual function and the retinal structure was investigated.Results:1.The relationship of retinal function and structure between acute and chronic CSCAccording to correlation analysis,in acute patients,Log MAR VA was significantly negatively correlated with MS0,MS4,MS20,and MSLP(P<0.05);Log MAR VA was significantly positively correlated with CRT,SRDH at the macular fovea,and the area of SRF(P<0.05).There was no significant correlation between MS0 and CCT,CRT,SRDH at the macular fovea,and the area of SRF(P>0.05).MS4 was significantly negatively correlated with CRT and SRDH at the macular fovea(P<0.05),but not significantly correlated with CCT and the area of SRF(P>0.05).MS20 was significantly negatively correlated with CRT,SRDH at the macular fovea,and the area of SRF(P<0.05),but not significantly correlated with CCT(P>0.05).MSLP and SRDH at the leakage point showed a significant negative correlation(P<0.05).According to correlation analysis,there was no significant correlation between Log MAR VA and MS0,MS4,MS20,MSLP,CCT,CRT,SRDH at the macular fovea,the area of SRF in chronic patients(P>0.05).MS0,MS4,MS20 had no significant correlation with CCT,CRT,SRDH at the macular fovea,the area of SRF(P>0.05).There was no significant correlation between Log MAR VA,MS0,MS4,MS20,MSLP,CCT,CRT,SRDH at the macular fovea and the leakage point,the area of SRF in acute and chronic patients(P>0.05).There was a significant difference between MS0 and MSLP in acute patients(P<0.05),and MSLP was higher than MS0.There was no significant difference between MS4 and MSLP in acute patients(P>0.05).There was a significant difference between MS0 and MSLP in chronic patients(P<0.05),and MSLP was higher than MS0.There was no significant difference between MS4 and MSLP in chronic patients(P>0.05).2.The differences in retinal function and structure among different courses of CSCThere was no significant difference among Log MAR VA,MS0,MS4,MS20,MSLP,CCT,CRT,SRDH at the macular fovea and the area of SRF in different courses of disease(P>0.05);Compared with SRDH at the leakage point,there was a significant difference(P=0.008<0.05),and the course of the disease from 1 week to 2 weeks is significantly lower than that of patients with a course of less than 1 week(P<0.05),and patients with the course of the disease from 1 month to 3 months is significantly lower than the course of disease less than 1 week(P<0.05).3.The differences in retinal function and structure among different leakage points of CSCThere was no significant difference in Log MAR VA,MS0,MS4,MS20,MSLP,CCT,CRT,and SRDH at the macular fovea among different locations of leakage(P>0.05);the difference in the area of SRF was significant(P=0.043<0.05),and leakage point at 16 ～20 degree was significantly higher than that at 0～4 degree(P<0.05);leakage point at 16～20 degree was significantly higher than that at 4～8 degree(P<0.05);leakage point at 16 ～20 degree was significantly higher than that at 8～12degree(P<0.05).4.Characteristics of visual acuity in CSC with irregular detachmentThe highest point of retinal serous detachment in 6 eyes was not at the fovea,and 6 patients all were acute CSC.Combining OCT to locate the position of the highest point of serous detachment,it is found that the4 degrees MS of the retina around the highest point of serous detachment(average 3.4d B)is much lower than that of the highest point of serous detachment located in the center of the macula(average MS0: 13.9d B,average MS4: 17.0d B).Conclusion:1.The retinal function of patients with acute CSC is related to the retinal structure indexes such as SRDH at the macular fovea,CRT,the area of SRF,and the position with the highest serous retinal detachment has the lowest retinal sensitivity.2.The course of the disease and the location of the leakage point have no significant effect on the changes in the retinal function and structure of CSC.3.There is no significant correlation between CCT and visual function in CSC patients,and the course of CSC and the location of the leakage point have no significant effect on CCT.4.Promoting the absorption of subretinal fluid is beneficial to the early recovery of visual function and reduces the irreversible damage of retinal function.