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

PURPOSE: To determine a correlation between foveal morpbologic 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 mu m, 103.2 mu m, and 124.9 mu m, 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. (Am J Ophthalmol 2009; 148:105-110. (C) 2009 by Elsevier Inc. All rights reserved.)