Correlation between Status of Foveal Inner Segment/Outer Segment Line and External Limiting Membrane Layer Integrity and Visual Outcome in Acute Central Serous Chorioretinopathy

Purpose: To evaluate the correlation between inner segment/outer segment (IS/OS) line and external limiting membrane (ELM) layer integrity at foveal center and visual outcome and to investigate the prognostic factors in optical coherence tomography (OCT) that related to final visual acuity (VA) and recovery time in acute central serous chorioretinopathy (CSC) Methods: We prospectively studied 108 consecutive patients (114 eyes) with acute CSC. The status of IS/OS line and ELM layer in the foveal center were assessed using OCT at initial and follow-up observation. OCT parameters including subretinal fluid (SRF) height (h), SRF width (w), central retinal thickness (r), total central foveal thickness (f), macular volume, and SRF surface were measured. Results: Ninety-four eyes (49 OD and 45 OS) from 88 patients (70 men and 18 women) were enrolled. No correlation was found between the total central foveal thickness at the center of the fovea and the final best corrected visual acuity (BCVA) levels (p=0.51). Final BCVA in patient with intact IS/OS junction and intact ELM at the fovea was significantly greater compared with absent or interrupted groups. We found significant correlation between the BCVA at the first visit and the final levels (p≤0.0001; r=0.69). Also there was significant correlation between final BCVA and recovery period (p≤0.0001; r=0.47). Although, there was no correlation between the recovery period and subretinal fluid volume, SRF height, SRF width, and SRF surface area, but there was correlation between the recovery period with SRF height to width ratio (p=0.0052; r=0.26). Conclusion: We reported that absence or interruption of foveal IS/OS junction and ELM layer, poor VA at initial visit, systemic diseases, use of certain drugs, and SRF height to width ratio in OCT is associated with poor final VA or longer duration of recovery time which in turn causes poor final VA in acute CSC.