Abstract
Objectives
To investigate the threshold thickness of the foveal outer nuclear layer (ONL) associated with favourable visual outcome after half-dose photodynamic therapy (PDT) in patients with central serous chorioretinopathy (CSC).
Methods
The CSC patients were divided into two groups according to whether their best-corrected visual acuity (BCVA) at 1 year after half-dose PDT was 20/20 or worse than 20/20. Three multivariable logistic regression models were respectively created to determine the prognostic value of the pre-PDT foveal ONL thickness, the pre- and the post-PDT foveal ONL thickness ratio, which was defined as the foveal ONL thickness in the CSC eye to that in the normal contralateral eye, for predicting the outcome of half-dose PDT. The areas under the receiver operating characteristic curves (AUCs) were compared and the best cut-off values were determined, respectively.
Results
Totally, 134 patients were included. The pre-PDT foveal ONL thickness, the pre-PDT and the post-PDT foveal ONL thickness ratios were all independent predictors of the outcome after half-dose PDT in their respective model (all P < 0.05). The AUC of the post-PDT foveal ONL thickness ratio was significantly higher than the AUCs of the other two parameters (0.940 vs 0.840 and 0.882, DeLong test: both P < 0.05), with the cut-off value of 0.81.
Conclusions
The threshold of the foveal ONL thickness ratio is 0.81. Active CSC eyes with a foveal ONL thickness ratio of 0.81 or more could probably retain BCVA of 20/20 after half-dose PDT. They were considered reasonable to wait for spontaneous resolution of sub-retinal fluid.
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Acknowledgements
This research was supported by the National Natural Science Foundation of China (Grant nos. 81870670 and 81900867), the Shanghai Committee of Science and Technology (Grant no.18411965100), and the Shanghai clinical three-year action plan-major clinical research project (SHDC2020CR2041B).
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QC and GX contributed equally as co-corresponding authors. CQ and XG designed the study. YX and LL performed the photodynamic therapy. YJ, YX, and LL collected the data. YJ, CQ, and JC analysed and interpreted the data. YJ was a major contributor in writing the manuscript. YX and LL participated in drafting the manuscript. CQ, XG, and JC revised the manuscript. All authors approved the final version and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
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This retrospective study was approved by the Ethics Committee of the Eye & Ear, Nose, Throat Hospital of Fudan University Shanghai China (2020052).
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The authors declare no competing interests.
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Yu, J., Ye, X., Li, L. et al. Threshold thickness of foveal outer nuclear layer associated with outcomes of photodynamic therapy in central serous chorioretinopathy. Eye 36, 1884–1889 (2022). https://doi.org/10.1038/s41433-021-01762-0
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DOI: https://doi.org/10.1038/s41433-021-01762-0
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