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ORIGINAL ARTICLE
Year : 2021  |  Volume : 33  |  Issue : 4  |  Page : 461-467

Dark-Field Scanning Laser Ophthalmoscopy for Prediction of Central Serous Chorioretinopathy Responsiveness to Laser Therapy


1 Department of Ophthalmology, Military Medical Academy, Saint Petersburg, Russia
2 UPMC Eye Center, University of Pittsburgh, Pittsburgh, PA, USA

Correspondence Address:
Dmitrii S Maltsev
Department of Ophthalmology, Military Medical Academy, 21 Botkinskaya Str., Saint Petersburg, 194044
Russia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joco.joco_257_21

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Purpose: To study the potential of dark-field scanning laser ophthalmoscopy (DF-SLO) for the prediction of central serous chorioretinopathy (CSC) responsiveness to laser therapy. Methods: Fifty-two eyes of 52 patients (44 males and 8 females, mean age of 45.4 ± 8.8 years) newly diagnosed with CSC were included in this prospective cohort study. At baseline, all patients received multimodal imaging including DF-SLO and then were observed until resolution of subretinal fluid or, in nonresolving cases, treated with laser therapy. At the end of the follow-up, each case was categorized as either self-resolving, resolving after laser treatment, or nonresolving after laser treatment. Presence of granular retinal pigment epithelium (RPE) changes and lucency of RPE/choroid complex at the leak on DF-SLO images were used by two masked graders to identify cases nonresolving after laser treatment. Results: Using DF-SLO images, the masked grader correctly classified 45 of 52 (86.5%) CSC cases. Kappa value for the classification by two graders was 0.95 (95% confidential interval [CI] 0.85–1.0). The area under the receiver operating curve, sensitivity, and specificity of DF-SLO in identifying nonresolving after laser treatment cases were 0.92 (95% CI: 0.79–0.98), 86.7% (95% CI: 59.5%–98.3%), and 96.6% (95% CI: 82.2%–99.2%), respectively. Conclusion: DF-SLO may be a useful technique in prognostication of response to laser treatment in newly diagnosed CSC.


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