title: En face enhanced-depth swept-source optical coherence tomography features of chronic central serous chorioretinopathy.
abstract: OBJECTIVE
  To characterize en face features of the retinal pigment epithelium (RPE) and choroid in eyes with chronic central serous chorioretinopathy (CSCR) using a high-speed, enhanced-depth swept-source optical coherence tomography (SS-OCT) prototype.
  
  
  METHODS
  Consecutive patients with chronic CSCR were prospectively examined with SS-OCT.
  
  
  METHODS
  Fifteen eyes of 13 patients.
  
  
  METHODS
  Three-dimensional 6×6 mm macular cube raster scans were obtained with SS-OCT operating at 1050 nm wavelength and 100000 A-lines/sec with 6 μm axial resolution. Segmentation of the RPE generated a reference surface; en face SS-OCT images of the RPE and choroid were extracted at varying depths every 3.5 μm (1 pixel). Abnormal features were characterized by systematic analysis of multimodal fundus imaging, including color photographs, fundus autofluorescence, fluorescein angiography, and indocyanine-green angiography (ICGA).
  
  
  METHODS
  En face SS-OCT morphology of the RPE and individual choroidal layers.
  
  
  RESULTS
  En face SS-OCT imaging at the RPE level revealed absence of signal corresponding to RPE detachment or RPE loss in 15 of 15 (100%) eyes. En face SS-OCT imaging at the choriocapillaris level showed focally enlarged vessels in 8 of 15 eyes (53%). At the level of Sattler's layer, en face SS-OCT documented focal choroidal dilation in 8 of 15 eyes (53%) and diffuse choroidal dilation in 7 of 15 eyes (47%). At the level of Haller's layer, these same features were observed in 3 of 15 eyes (20%) and 12 of 15 eyes (80%), respectively. In all affected eyes, these choroidal vascular abnormalities were seen just below areas of RPE abnormalities. In 2 eyes with secondary choroidal neovascularization (CNV), distinct en face SS-OCT features corresponded to the neovascular lesions.
  
  
  CONCLUSIONS
  High-speed, enhanced-depth SS-OCT at 1050 nm wavelength enables the visualization of pathologic features of the RPE and choroid in eyes with chronic CSCR not usually appreciated with standard spectral domain (SD) OCT. En face SS-OCT imaging seems to be a useful tool in the identification of CNV without the use of angiography. This in vivo documentation of the RPE and choroidal vasculature at variable depths may help elucidate the pathophysiology of disease and can contribute to the diagnosis and management of chronic CSCR.
authors.affiliation: New England Eye Center, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Daniela
authors.initials: D
authors.lastname: Ferrara
authors.affiliation: Department of Electrical Engineering and Computer Science and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts; Faculty of Physics, Ludwig-Maximilians-University Munich, Munich, Germany.
authors.forename: Kathrin J
authors.initials: KJ
authors.lastname: Mohler
authors.affiliation: New England Eye Center, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Nadia
authors.initials: N
authors.lastname: Waheed
authors.affiliation: New England Eye Center, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Mehreen
authors.initials: M
authors.lastname: Adhi
authors.affiliation: Department of Electrical Engineering and Computer Science and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts.
authors.forename: Jonathan J
authors.initials: JJ
authors.lastname: Liu
authors.affiliation: Department of Electrical Engineering and Computer Science and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts.
authors.forename: Ireneusz
authors.initials: I
authors.lastname: Grulkowski
authors.affiliation: Department of Electrical Engineering and Computer Science and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts; Pattern Recognition Lab and Graduate School in Advanced Optical Technologies, University Erlangen-Nuremburg, Erlangen-Nuremburg, Germany.
authors.forename: Martin F
authors.initials: MF
authors.lastname: Kraus
authors.affiliation: New England Eye Center, Tufts Medical Center, Boston, Massachusetts.
authors.forename: Caroline
authors.initials: C
authors.lastname: Baumal
authors.affiliation: Pattern Recognition Lab and Graduate School in Advanced Optical Technologies, University Erlangen-Nuremburg, Erlangen-Nuremburg, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Hornegger
authors.affiliation: Department of Electrical Engineering and Computer Science and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts.
authors.forename: James G
authors.initials: JG
authors.lastname: Fujimoto
authors.affiliation: New England Eye Center, Tufts Medical Center, Boston, Massachusetts. Electronic address: jduker@tuftsmedicalcenter.org.
authors.forename: Jay S
authors.initials: JS
authors.lastname: Duker
mesh_terms: D056833:Central Serous Chorioretinopathy / Q000175:diagnosis*; D002829:Choroid / Q000473:pathology*; D002908:Chronic Disease; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055213:Retinal Pigment Epithelium / Q000473:pathology*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green