Comparative evaluation of central serous retinopathy in pilots and non-pilot patients

Abstract

Background

Central serous chorioretinopathy (CSC) is a disqualifying condition for pilots because of the importance of good vision to their jobs. The objective of this study was to evaluate the clinical diagnosis, treatment, and aviation medical assessment principles for CSC in military pilots.

Methods

The clinical data and aviation medical assessments of 15 pilots with CSC who were admitted to the Air Force Medical Center between January 2003 and December 2021 were analyzed, and three typical cases were reported. The relevant literature evaluation was conducted on 32 non-pilot patients with CSC.

Results

The mean age of the 15 pilots was 37.47 ± 4.21 years, and they were all male. Fourteen were affected in a single eye (4 in the right eye and 10 in the left eye), while one was affected in both eyes. Two pilots were nonsmokers and did not consume alcohol; one was a smoker; four pilots consumed alcohol on a regular basis; and eight pilots were smokers and consumed alcohol on a regular basis. The mean best-corrected visual acuity (BCVA) increased from 0.83 ± 0.33 at the initial visit to 0.95 ± 0.44 at the final visit. The non-pilot group included 32 patients, 29 of whom were male and 3 of whom were female, with a mean age of 37.16 ± 10.02 years. Thirty-one patients had single-eye involvement (17 of the right eye and 14 of the left eye), while one patient had involvement of both eyes. Seventeen patients were nonsmokers and did not consume alcohol; two were smokers; four consumed alcohol on a regular basis; and nine were smokers and consumed alcohol on a regular basis. The mean BCVA increased from 0.64 ± 0.28 at the first visit to 0.90 ± 0.30 at the final visit. Patients in the pilot group had a high recurrence rate, which was associated with a low final BCVA and led to their disqualification from flying.

Conclusion

Pilot and non-pilot patients did not differ significantly in terms of CSC clinical data. Chronic and recurrent CSC can be a vision-threatening disease; therefore, pilots must receive accurate and timely diagnosis.