Outer Nuclear Layer Thickness at the Fovea Determines Visual Outcomes in Resolved Central Serous Chorioretinopathy

Purpose

To determine a correlation between foveal morphologic changes and visual outcomes in patients with resolved central serous chorioretinopathy (CSC).

Design

Observational case series.

Methods

We measured the outer nuclear layer (ONL) thickness at the central fovea and evaluated the integrity of the photoreceptor inner and outer segment junction (IS/OS) using spectral-domain optical coherence tomography in 67 eyes (65 patients) with resolved CSC. The patients were divided into 2 groups: group A included 24 eyes (23 patients) with best-corrected visual acuity (BCVA) of less than 1.0, and group B included 43 eyes (42 patients) with BCVA of 1.0 or better. Group C was comprised of normal control eyes (10 volunteers). We also determined a correlation between the ONL thickness and BCVA.

Results

The average ONL thicknesses at the central fovea in groups A, B, and C were 74.6 μm, 103.2 μm, and 124.9 μm, respectively. The average ONL thickness at the central fovea in group A was significantly (P < .001) thinner than that in group B, and that in group B was significantly (P = .0014) thinner than that in group C. The ONL thickness was correlated with the BCVA (r_s = 0.59; P < .001). Discontinuity of the IS/OS line was observed in 22 eyes (91.7%) in group A, in 9 eyes (20.9%) in group B, and in no eyes in group C, with the difference between groups A and B reaching significance (P < .001).

Conclusions

The ONL thickness is positively correlated with the BCVA in resolved CSC. Discontinuity of the IS/OS line was prevalent in eyes with thinner ONL and lower BCVA.