Fundus autofluorescence and central serous chorioretinopathy.
OBJECTIVE
To investigate the autofluorescence characteristics in patients with central serous chorioretinopathy.


METHODS
Observational case series.


METHODS
Thirty consecutive patients examined in a private referral practice.


METHODS
Patients were imaged with autofluorescence photography, fundus photography, fluorescein angiography, and optical coherence tomography (OCT). The mean and standard deviation (SD) of the grayscale values from a 100-pixel-diameter circle centered on the fovea were obtained and normalized with the level of autofluorescence of the posterior pole.


RESULTS
There were 30 patients, 23 male (76.7%) and 7 female (23.3%), with a median visual acuity (VA) of 20/25 and a range of 20/15 to 20/400. Stepwise linear regression that included individual fixed effects found that normalized central macular autofluorescence (P < 0.001), pigment mottling in the fovea (P = 0.045), subfoveal fluid detected by OCT (P = 0.033), and the SD of the central macular autofluorescence (P = 0.025) produced a highly significant model (R2 = 0.92, P < < 0.001) predicting VA. Increasing levels of autofluorescence were correlated with accumulation of material on the outer surface of the retina as seen by OCT. Decreased central macular autofluorescence, particularly in those eyes with central geographic retinal pigment epithelial atrophy, was associated with poor VA.


CONCLUSIONS
This study established that autofluorescence changes occurring in central serous chorioretinopathy with explicit patterns can be measured in a noninvasive manner, and this information can be used to estimate the damage induced by central serous chorioretinopathy with a high degree of statistical significance. We hypothesize that the material on the outer surface of the elevated retina may represent accumulation of photoreceptor outer segments secondary to the lack of direct apposition and phagocytosis by the retinal pigment epithelium.
Spaide
Richard F
RF
Vitreous, Retina, Macula Consultants of New York and the LuEsther T. Mertz Retina Research Laboratory, Manhattan Eye, Ear, and Throat Hospital, New York, New York, USA. rickspaide@yahoo.com
Klancnik
James M
JM
D001769:Blood; D005260:Female; D005451:Fluorescein Angiography; D005453:Fluorescence; D005654:Fundus Oculi; D006801:Humans; D008062:Lipofuscin / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010781:Photography; D010857:Pigment Epithelium of Eye / Q000378:metabolism / Q000473:pathology*; D012164:Retinal Diseases / Q000175:diagnosis* / Q000378:metabolism; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
D008062:Lipofuscin