Morphologic changes in acute central serous chorioretinopathy evaluated by fourier-domain optical coherence tomography.
OBJECTIVE
To investigate morphologic alterations around fluorescein leakage sites using Fourier-domain optical coherence tomography (FD OCT) in acute central serous chorioretinopathy (CSC).


METHODS
Observational case series.


METHODS
Twenty-one eyes with acute CSC with subjective symptoms for under 3 months.


METHODS
Patients underwent measurement of visual acuity, fundus observations, and FD OCT examinations at every visit with the intervals of 2 to 4 weeks until subretinal fluid (SRF) resolved. Fluorescein angiography was performed at baseline to confirm dye leakage sites. Horizontal and vertical OCT scans (B-scans and consecutive raster scans) of the fovea and fluorescein leakage sites were obtained.


METHODS
Morphologic changes in the retinal pigment epithelium (RPE), detached retina, and subretinal space around the leakage sites were evaluated repeatedly during follow-up.


RESULTS
The mean period between baseline and the final examination was 108 days (mean no. of examinations, 3.9). Among 23 leakage sites in 21 eyes, FD OCT showed RPE abnormalities in 22 (96%) sites (14 sites [61%] with a pigment epithelial detachment [PED] and 8 [35%] with a protruding or irregular RPE layer). Fibrinous exudates in the subretinal space and sagging/dipping of the posterior layer of the neurosensory retina above the leakage sites were seen at 12 (52%) and 10 (43%) leakage points, respectively. An RPE defect at the edge of or within the PED was observed in 5 leakage sites (22%); in 2 of these, a defect was detectable after the SRF decreased. The posterior surface of the detached retina was smooth in 17 eyes (81%) and granulated in 4 eyes (19%) (mean duration of subjective symptoms, 10 days and 42 days, respectively). The smooth posterior detached retina became granulated in the presence of residual SRF. A PED remained at the 5 leakage sites in 5 eyes (22%) despite SRF resolution.


CONCLUSIONS
Fourier-domain OCT examinations showed detailed morphologic changes in eyes with acute CSC including an RPE defect within the PED at a leakage site through which fluid might pass from the sub-RPE to the subretinal area. Fourier-domain OCT findings may offer new information to facilitate understanding of the mechanisms of acute CSC.
Fujimoto
Hisataka
H
Department of Ophthalmology, Osaka University Medical School, Suita, Osaka, Japan.
Gomi
Fumi
F
Wakabayashi
Taku
T
Sawa
Miki
M
Tsujikawa
Motokazu
M
Tano
Yasuo
Y
D000208:Acute Disease; D000328:Adult; D000368:Aged; D001813:Blood-Retinal Barrier; D002199:Capillary Permeability; D002829:Choroid / Q000098:blood supply; D015862:Choroid Diseases / Q000175:diagnosis*; D005122:Exudates and Transudates; D005260:Female; D019793:Fluorescein / Q000378:metabolism; D005451:Fluorescein Angiography; D005583:Fourier Analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010857:Pigment Epithelium of Eye / Q000473:pathology*; D011446:Prospective Studies; D012164:Retinal Diseases / Q000175:diagnosis*; D044967:Serum; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
D019793:Fluorescein