Staphyloma-induced Serous Maculopathy: Natural Course and Treatment Effects

Monica Ravenstijn*, José P. Martinez Ciriano, Gerard W. de Graaf, Caroline C.W. Klaver, Suzanne Yzer

*Corresponding author for this work

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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, sex, spherical equivalent, 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 1 patient. Main Outcome Measures: Changes in SRD height and BCVA. Results: Twenty-six eyes of 20 patients (70% female) were included. The mean age was 54 ± 11 years, and the mean spherical equivalent was −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%). The 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 (interquartile range 14–57) months. Treatment was performed in 20 eyes (77%) and led to resolution of SRD in 3 of the 15 photodynamic therapy treatments (21%), 2 of 5 (40%) anti-VEGF series, and 2 of 4 eyes (50%) treated with topical prednisolone. Best-corrected visual acuity at the final visit (0.42 ± 0.25) was not significantly different from BCVA at baseline (0.34 ± 0.27 logarithm of the minimum angle of resolution, P = 0.07), nor was BCVA change significantly different between treated eyes (n = 19) and nontreated eyes (n = 7, P = 0.3). Conclusion: Serous retinal detachment in patients with SISM fluctuated over time and resolved without treatment in 31% of the eyes. Because treatment does not change the course of BCVA, a wait-and-see policy is advocated in these patients on the exclusion of treatable causes of SRD. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Original languageEnglish
Pages (from-to)499-508
Number of pages10
JournalOphthalmology Retina
Volume8
Issue number5
Early online date22 Nov 2023
DOIs
Publication statusPublished - May 2024

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Publisher Copyright:
© 2023 American Academy of Ophthalmology

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