Alterations of intraretinal layers in acute central serous chorioretinopathy.
OBJECTIVE
Optical coherence tomography (OCT) is restricted by its low scanning speed and limited resolution. High-definition raster-scanning OCT (HD-OCT) was used to evaluate changes in retinal microstructure in patients with acute central serous chorioretinopathy (CSCR) and to find new morphological features.


METHODS
Eighteen patients with subretinal fluid accumulation caused by acute CSCR were imaged in a cross-sectional study design. High-speed frequency-domain HD-OCT was used to image an area of 6 x 6 mm in the macular retina. Three-dimensional analyses were performed using en-face imaging and section analysis of single HD-OCT scans.


RESULTS
Detailed information about fluid accumulation can be obtained in all compartments. Discrete changes in reflectivity are visualized within the outer nuclear or plexiform layers in > 90% of patients. Subretinal fluid appears as a dome-shaped pool of fluid and is not associated with a loss of photoreceptor layer integrity. Deposits are demarcated beneath the outer cone segments. Multiple small pigment epithelial detachments are present in > 60% of patients.


CONCLUSIONS
High-definition OCT provides extensive information regarding precise topographic and layer-specific localization of discrete morphological changes. Along with well-known changes in the retinal microstructure, hyper-reflectivity can be imaged in the outer nuclear or plexiform layers and may represent intraretinal changes indicating the presence of subretinal pathologies or retinal maladjustment caused by the underlying pathology.
Ahlers
Christian
C
Department of Ophthalmology, Medical University of Vienna, Austria.
Geitzenauer
Wolfgang
W
Stock
Geraldine
G
Golbaz
Isabelle
I
Schmidt-Erfurth
Ursula
U
Prünte
Christian
C
D000208:Acute Disease; D000328:Adult; D001826:Body Fluids / Q000378:metabolism; D015862:Choroid Diseases / Q000175:diagnosis* / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D020419:Photoreceptor Cells, Vertebrate / Q000473:pathology; D012160:Retina / Q000378:metabolism / Q000473:pathology; D012163:Retinal Detachment / Q000175:diagnosis* / Q000378:metabolism; D055213:Retinal Pigment Epithelium / Q000473:pathology; D041623:Tomography, Optical Coherence / Q000379:methods*