title: Does microperimetry have a prognostic value in central serous chorioretinopathy?
abstract: OBJECTIVE
  To investigate the relationship between retinal sensitivity and persistence of subretinal fluid and then to analyze microperimetry as a prognostic predictor of acute central serous chorioretinopathy.
  
  
  METHODS
  A prospective observational study. Fourteen eyes of 14 patients presenting with first episode acute central serous chorioretinopathy were enrolled and underwent ocular examination, spectral domain optical coherence tomography, and MAIA microperimetry were performed. After three months of follow-up, without any treatment, visual acuity and spectral domain optical coherence tomography macular thickness assessments and microperimetry were repeated. The main outcome was to find a relation between initial macular sensitivity and persistence of subretinal fluid. A receiver operating characteristic curve was plotted to indicate the best macular sensitivity cutoff point that would be able to predict whether a patient with acute central serous chorioretinopathy would progress to the chronic form. According to the cutoff, we calculated the sensitivity, specificity, and positive and negative predictive values for macular sensitivity as a method to predict persistence of subretinal fluid.
  
  
  RESULTS
  On the basis of the receiver operating characteristic curve, a cutoff of 20 dB macular sensitivity was obtained, as the best balance between sensitivity and specificity to predict chronicity. Using this cutoff, the method had a sensitivity of 71% and specificity of 100% with a positive predictive value of 100% and negative predictive value of 78%. Furthermore, it was found that eyes with acute central serous chorioretinopathy and microperimetry of less than 20 dB had a relative risk of 4.5 to develop subretinal fluid persistence.
  
  
  CONCLUSIONS
  Microperimetry with a cutoff of 20 dB may be a useful test to predict the persistence of subretinal fluid, allowing the ophthalmologist to use treatment tools earlier, preventing extracellular damage and visual impairment.
authors: *Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil; and †Department of Physiology and Pharmacology, Federal University of Ceara, Fortaleza, Brazil.
authors: Luiz
authors: L
authors: Roisman
authors: João C
authors: JC
authors: Ribeiro
authors: Francisco V
authors: FV
authors: Fechine
authors: Daniel
authors: D
authors: Lavinsky
authors: Nilva
authors: N
authors: Moraes
authors: Mauro
authors: M
authors: Campos
authors: Michel E
authors: ME
authors: Farah
mesh_terms: D000208:Acute Disease; D000328:Adult; D056833:Central Serous Chorioretinopathy / Q000175:diagnosis* / Q000503:physiopathology; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012160:Retina / Q000503:physiopathology*; D012680:Sensitivity and Specificity; D058471:Subretinal Fluid; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests / Q000379:methods*