title: Fundus autofluorescence in acute and chronic-recurrent central serous chorioretinopathy.
abstract: OBJECTIVE
  Central serous chorioretinopathy (CSC) affects mostly young and middle-aged adults. Typically, a serous retinal detachment occurs with a focal leakage point in fluorescein angiography. Fundus autofluorescence (AF) is related to the lipofuscin within the retinal pigment epithelium (RPE). As CSC is thought to be associated with RPE disorders, AF measurements might be able to detect distinct changes within the RPE level. The purpose of this study was to compare AF patterns in acute and chronic-recurrent CSC and to evaluate the potential value of AF as a non-invasive monitoring tool.
  
  
  METHODS
  From 85 patients diagnosed with CSC (mean age 43 years), AF images were retrospectively evaluated and compared with angiographic and ophthalmoscopic findings. Fluorescein angiography and AF measurements were performed using a Heidelberg retina angiograph. Autofluorescence was excited at a wavelength of 488 nm and detected above 500 nm.
  
  
  RESULTS
  Acute CSC as determined by an acute decrease in visual acuity (VA) within the last 6 weeks, focal point leakage and neurosensory retinal detachment was diagnosed in 39 patients. In 36 of those patients (92%), a significantly decreased AF at the leakage point (72%) and/or decreased AF in the area of neurosensory detachment (77%) were observed. Regarding chronic-recurrent CSC as determined by a decrease in VA for longer than 6 weeks and mottled hyperfluorescent appearance in angiography, abnormalities in AF were observed in 44/46 patients (96%). In those patients, decreased or mottled AF was observed at the leakage point itself (76%), whereas significantly increased AF was seen in the area of residual neurosensory retinal detachment (85%).
  
  
  CONCLUSIONS
  In acute CSC, decreased AF is presumably due to a blockage caused by oedema, whereas in chronic-recurrent forms, irregular and increased AF is observed, possibly reflecting reactive RPE changes secondary to RPE defects and neurosensory detachment. If these findings could be systematically underlined by prospective clinical studies, AF might be an interesting non-invasive tool for monitoring RPE changes in CSC and for performing differential diagnosis.
authors.affiliation: University Eye Hospital Regensburg, Regensburg, Germany. carsten.framme@klinik.uni-regensburg.de
authors.forename: Carsten
authors.initials: C
authors.lastname: Framme
authors.forename: Andreas
authors.initials: A
authors.lastname: Walter
authors.forename: Bernhard
authors.initials: B
authors.lastname: Gabler
authors.forename: Johann
authors.initials: J
authors.lastname: Roider
authors.forename: Helmut G
authors.initials: HG
authors.lastname: Sachs
authors.forename: Veit-Peter
authors.initials: VP
authors.lastname: Gabel
mesh_terms: D000208:Acute Disease; D000328:Adult; D001769:Blood; D002908:Chronic Disease; D005122:Exudates and Transudates; D005260:Female; D005451:Fluorescein Angiography; D005453:Fluorescence; D005654:Fundus Oculi; D006801:Humans; D008062:Lipofuscin / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010857:Pigment Epithelium of Eye / Q000378:metabolism / Q000473:pathology*; D012008:Recurrence; D012163:Retinal Detachment / Q000175:diagnosis* / Q000378:metabolism; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
chemical_list: D008062:Lipofuscin