Prevalence and Morphologic Biomarkers of Metamorphopsia in eyes with "Resolved" Chronic Central Serous Chorioretinopathy

Purpose: To assess relationships between demographics, clinical characteristics and optical coherence tomography (OCT) characteristics with persistence of metamorphopsia after resolution of subretinal fluid in eyes with chronic central serous chorioretinopathy (CSC). Methods: One-hundred participants with "resolved" (absence of subretinal fluid) chronic CSC were retrospectively analyzed. Patients underwent a complete ophthalmological evaluation including assessment of presence of metamorphopsia. At the study visit, OCT scans were reviewed for qualitative and quantitative features. Results: Sixty-six out of 100 (66.0%) patients complained of metamorphopsia. Both the foveal and parafoveal ganglion cell complex (GCC) thicknesses were thinner in CSC eyes with metamorphopsia (35.1±10.6 μm and 82.0±18.1 μm vs. 40.7±11.8 μm and 93.1±13.5 μm, p=0.030 and p<0.0001). In the foveal region, the outer plexiform layer and outer nuclear layer (ONL) thicknesses were thinner in patients with metamorphopsia (24.6±8.5 μm and 63.1±20.9 μm vs. 29.1±8.7 and 76.2±18.2 μm, p=0.016 and p=0.005). The ellipsoid zone band was more frequently discontinued in eyes with metamorphopsia (56.1 % vs. 35.3%, p=0.039). Multivariate stepwise linear regression analysis demonstrated that the strongest associations with presence of metamorphopsia were with parafoveal GCC thickness (p=0.004), foveal ONL thickness (p=0.010), and number of previous recurrences of subretinal fluid accumulation (p=0.017). The time interval from the last subretinal fluid resolution was not associated with the presence of metamorphopsia. Conclusions: In "resolved" CSC, clinical aspects (i.e., number of previous recurrences) and structural changes (i.e., GCC and ONL thinning) are associated with metamorphopsia after subretinal fluid resolution.