{"title":"中心性浆液性脉络膜视网膜病变光动力疗法后视觉预后的预测风险评分。","authors":"Ryoh Funatsu, Hiroto Terasaki, Naohisa Mihara, Hideki Shiihara, Shozo Sonoda, Taiji Sakamoto","doi":"10.1007/s00417-024-06698-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To comprehensively evaluate baseline characteristics of patients with central serous chorioretinopathy (CSC) and develop predictive risk scores to identify visual prognosis.</p><p><strong>Methods: </strong>This single-institute, retrospective cohort study included 144 eyes of 144 patients with CSC who underwent photodynamic therapy and achieved serous retinal detachment resolution. We developed and assessed the performance of several risk scores for best-corrected visual acuity (BCVA) outcomes six months post-treatment: i) BCVA improvement (≤-1.0 logMAR), and ii) BCVA deterioration (≥+ 1.0 logMAR).</p><p><strong>Results: </strong>The BCVA improvement models used photoreceptor outer segment thickness, loss of photoreceptor outer segment, and neurosensory retinal thickness (NSRT), while the BCVA deterioration models included outer nuclear layer thickness and NSRT. The BCVA improvement models demonstrated a corrected area under the curve (AUC) of 0.786 (95% confidence interval [CI]: 0.699-0.864), with 80.4% sensitivity, and 71.2% specificity. The BCVA deterioration models achieved a corrected AUC of 0.864 (95% CI: 0.742-0.958), with 85.7% sensitivity, and 83.5% specificity.</p><p><strong>Conclusion: </strong>The predictive models for CSC exhibited favorable performance in predicting individual visual prognoses. A thinner outer nuclear layer may be associated with BCVA deterioration, whereas preservation of the photoreceptor outer segment may be correlated with BCVA improvement.</p><p><strong>Key messages: </strong>WHAT IS KNOWN : Pre-treatment best-corrected visual acuity, thickness of each sensory retinal layer, time from onset to treatment, and macular atrophy were each found to be associated with visual prognosis for patients with central serous chorioretinopathy (CSC).</p><p><strong>What is new: </strong>The current study comprehensively assessed potential prognostic factors and precisely identified individual likelihood of visual prognosis. The study found that different regions of the sensory retina were associated with either worsening or improving visual acuity. Accurately predicting visual outcomes after photodynamic therapy for CSC would help healthcare providers create personalized treatment plans and enable patients to make informed decisions about their treatment based on their expected visual results.</p>","PeriodicalId":12795,"journal":{"name":"Graefe’s Archive for Clinical and Experimental Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Predictive risk scores for visual prognosis after photodynamic therapy for central serous chorioretinopathy.\",\"authors\":\"Ryoh Funatsu, Hiroto Terasaki, Naohisa Mihara, Hideki Shiihara, Shozo Sonoda, Taiji Sakamoto\",\"doi\":\"10.1007/s00417-024-06698-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To comprehensively evaluate baseline characteristics of patients with central serous chorioretinopathy (CSC) and develop predictive risk scores to identify visual prognosis.</p><p><strong>Methods: </strong>This single-institute, retrospective cohort study included 144 eyes of 144 patients with CSC who underwent photodynamic therapy and achieved serous retinal detachment resolution. We developed and assessed the performance of several risk scores for best-corrected visual acuity (BCVA) outcomes six months post-treatment: i) BCVA improvement (≤-1.0 logMAR), and ii) BCVA deterioration (≥+ 1.0 logMAR).</p><p><strong>Results: </strong>The BCVA improvement models used photoreceptor outer segment thickness, loss of photoreceptor outer segment, and neurosensory retinal thickness (NSRT), while the BCVA deterioration models included outer nuclear layer thickness and NSRT. The BCVA improvement models demonstrated a corrected area under the curve (AUC) of 0.786 (95% confidence interval [CI]: 0.699-0.864), with 80.4% sensitivity, and 71.2% specificity. The BCVA deterioration models achieved a corrected AUC of 0.864 (95% CI: 0.742-0.958), with 85.7% sensitivity, and 83.5% specificity.</p><p><strong>Conclusion: </strong>The predictive models for CSC exhibited favorable performance in predicting individual visual prognoses. A thinner outer nuclear layer may be associated with BCVA deterioration, whereas preservation of the photoreceptor outer segment may be correlated with BCVA improvement.</p><p><strong>Key messages: </strong>WHAT IS KNOWN : Pre-treatment best-corrected visual acuity, thickness of each sensory retinal layer, time from onset to treatment, and macular atrophy were each found to be associated with visual prognosis for patients with central serous chorioretinopathy (CSC).</p><p><strong>What is new: </strong>The current study comprehensively assessed potential prognostic factors and precisely identified individual likelihood of visual prognosis. The study found that different regions of the sensory retina were associated with either worsening or improving visual acuity. Accurately predicting visual outcomes after photodynamic therapy for CSC would help healthcare providers create personalized treatment plans and enable patients to make informed decisions about their treatment based on their expected visual results.</p>\",\"PeriodicalId\":12795,\"journal\":{\"name\":\"Graefe’s Archive for Clinical and Experimental Ophthalmology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-11-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Graefe’s Archive for Clinical and Experimental Ophthalmology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00417-024-06698-1\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Graefe’s Archive for Clinical and Experimental Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00417-024-06698-1","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Predictive risk scores for visual prognosis after photodynamic therapy for central serous chorioretinopathy.
Purpose: To comprehensively evaluate baseline characteristics of patients with central serous chorioretinopathy (CSC) and develop predictive risk scores to identify visual prognosis.
Methods: This single-institute, retrospective cohort study included 144 eyes of 144 patients with CSC who underwent photodynamic therapy and achieved serous retinal detachment resolution. We developed and assessed the performance of several risk scores for best-corrected visual acuity (BCVA) outcomes six months post-treatment: i) BCVA improvement (≤-1.0 logMAR), and ii) BCVA deterioration (≥+ 1.0 logMAR).
Results: The BCVA improvement models used photoreceptor outer segment thickness, loss of photoreceptor outer segment, and neurosensory retinal thickness (NSRT), while the BCVA deterioration models included outer nuclear layer thickness and NSRT. The BCVA improvement models demonstrated a corrected area under the curve (AUC) of 0.786 (95% confidence interval [CI]: 0.699-0.864), with 80.4% sensitivity, and 71.2% specificity. The BCVA deterioration models achieved a corrected AUC of 0.864 (95% CI: 0.742-0.958), with 85.7% sensitivity, and 83.5% specificity.
Conclusion: The predictive models for CSC exhibited favorable performance in predicting individual visual prognoses. A thinner outer nuclear layer may be associated with BCVA deterioration, whereas preservation of the photoreceptor outer segment may be correlated with BCVA improvement.
Key messages: WHAT IS KNOWN : Pre-treatment best-corrected visual acuity, thickness of each sensory retinal layer, time from onset to treatment, and macular atrophy were each found to be associated with visual prognosis for patients with central serous chorioretinopathy (CSC).
What is new: The current study comprehensively assessed potential prognostic factors and precisely identified individual likelihood of visual prognosis. The study found that different regions of the sensory retina were associated with either worsening or improving visual acuity. Accurately predicting visual outcomes after photodynamic therapy for CSC would help healthcare providers create personalized treatment plans and enable patients to make informed decisions about their treatment based on their expected visual results.
期刊介绍:
Graefe''s Archive for Clinical and Experimental Ophthalmology is a distinguished international journal that presents original clinical reports and clini-cally relevant experimental studies. Founded in 1854 by Albrecht von Graefe to serve as a source of useful clinical information and a stimulus for discussion, the journal has published articles by leading ophthalmologists and vision research scientists for more than a century. With peer review by an international Editorial Board and prompt English-language publication, Graefe''s Archive provides rapid dissemination of clinical and clinically related experimental information.