Predictive Genes for the Prognosis of Central Serous Chorioretinopathy

Purpose: To investigate potential genetic prognostic factors associated with spontaneous resolution of serous retinal detachment (SRD) and development of choroidal neovascularization (CNV) in central serous chorioretinopathy (CSC). Design: Retrospective analysis of a case series. Participants: One hundred ninety-six eyes from 196 patients with active CSC. Methods: We retrospectively reviewed medical records and determined the presence or absence of SRD using OCT imaging. The duration until the spontaneous SRD resolution was analyzed using the Kaplan-Meier method, and associations between the duration to spontaneous resolution and Complement factor H (CFH) 162V, Age-Related Maculopathy Susceptibility 2 (ARMS2) A69S, or Vasoactive Intestinal Peptide Receptor 2 (VIPR2) rs3793217 genotypes were evaluated, followed by the assessment of their associations with CNV that developed secondary to CSC. Main Outcome Measures: Genetic associations of CFH rs800292, ARMS2 rs10490924, and VIPR2 rs3793217 genotypes with the duration to spontaneous resolution of SRD and development of CNV during follow-up of CSC. Results: In 105 of the 196 study participants, we revealed spontaneous SRD resolution in their eyes during follow-up evaluation. Sixty-eight eyes received treatment, and 23 eyes dropped out before spontaneous SRD resolution. Among the 3 genetic polymorphisms assessed herein, only the CFH 162V genotype was predictive of spontaneous SRD resolution among its genotypes (P = 0.017); the average durations for the spontaneous SRD resolution for the individuals with AA, AG, and GG genotype were 126.6 +/- 115.5 days, 157.7 +/- 243.1 days, and 242.7 +/- 198.0 days, respectively, indicating that the G allele was associated with significantly longer persistent SRD (P = 0.035). Among the total number of eyes of all participants, 14 demonstrated CNV during follow-up evaluation. The CFH 162V G and ARMS2 A69S T alleles were associated significantly with CNV development (P = 0.0023 and P = 0.019, respectively), whereas the VIPR2 rs3793217 genotype was not. Conclusions: The CFH 162V and ARMS2 A69S genotypes can predict the prognosis of CSC. Knowledge of the genetic status may help physicians determine the need for early treatment and possibly prevent subsequent CNV development. Further prospective studies are needed to confirm the observed genotype-phenotype relationship. (C) 2019 by the American Academy of Ophthalmology