May 2007
Volume 48, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2007
Staging of Central Serous Chorioretinopathy With High-speed Ultrahigh Resolution OCT
Author Affiliations & Notes
  • R. W. Chen
    Tufts-New England Eye Center, Boston, Massachusetts
  • V. J. Srinivasan
    Dept. of Electrical Engineering and Computer Science and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts
  • J. S. Duker
    Tufts-New England Eye Center, Boston, Massachusetts
  • E. Reichel
    Tufts-New England Eye Center, Boston, Massachusetts
  • C. R. Baumal
    Tufts-New England Eye Center, Boston, Massachusetts
  • A. H. Rogers
    Tufts-New England Eye Center, Boston, Massachusetts
  • T. Hedges
    Tufts-New England Eye Center, Boston, Massachusetts
  • M. Wojtkowski
    Institute of Physics, Nicolaus Copernicus University, Torun, Poland
  • J. S. Schuman
    UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Dept. of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
  • J. G. Fujimoto
    Dept. of Electrical Engineering and Computer Science and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts
  • Footnotes
    Commercial Relationships R.W. Chen, None; V.J. Srinivasan, None; J.S. Duker, Optovue, Inc., F; E. Reichel, None; C.R. Baumal, None; A.H. Rogers, None; T. Hedges, None; M. Wojtkowski, None; J.S. Schuman, Optovue, Inc., F; Carl Zeiss Meditec, Inc., F; Heidelberg Engineering, F; Carl Zeiss Meditec, Inc., P; Carl Zeiss Meditec, Inc., R; Heidelberg Engineering, R; J.G. Fujimoto, Optovue, Inc., F; Carl Zeiss Meditec, Inc., P.
  • Footnotes
    Support NIH RO1-EY13178-06, RO1-EY11289-20, P30-EY08098, P30-EY13078, NSF ECS-0119452 and BES-0522845, AFOSR FA9550-040-1-0046, FA9550-040-1-0011, The Eye and Ear Fdn (Pittsburgh, PA), RPB unrestr. grant
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 2621. doi:
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      R. W. Chen, V. J. Srinivasan, J. S. Duker, E. Reichel, C. R. Baumal, A. H. Rogers, T. Hedges, M. Wojtkowski, J. S. Schuman, J. G. Fujimoto; Staging of Central Serous Chorioretinopathy With High-speed Ultrahigh Resolution OCT. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2621.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose:: To examine central serous chorioretinopathy (CSCR) with Ultrahigh resolution optical coherence tomography and high-speed, ultrahigh resolution OCT (UHR-OCT) based on spectral / Fourier domain detection. To investigate the impact of improved visualization of internal retinal layers on staging of CSCR.

Methods:: 22 patients with a clinical diagnosis of CSCR were scanned at the New England Eye Center with either a prototype UHR-OCT time domain instrument or a high-speed UHR-OCT instrument from January 2004 to November 2006. Both instruments achieved 3 - 3.5 µm axial image resolution, compared to ~10 µm resolution obtained by Stratus OCT. The high-speed UHR-OCT instrument images at a rate ~60 times faster than standard OCT, resulting in decreased motion artifacts and images with high transverse pixel density.

Results:: Three stages of CSCR were identified based on UHR-OCT image photoreceptor and retinal pigment epithelium (RPE) characteristics. Stage 1a patients (7 cases) had a uniformly elevated neurosensory retinal detachment with a smooth, normal thickness photoreceptor outer segment (PR OS) contour. Stage 1b patients (4) demonstrated a stalactite/stalagmite appearance on the outer segments and RPE, respectively. Stage 2 patients (4) lacked the protrusions of stage 1b, but the detached neurosensory retina had an irregular retinal contour and an unevenly thinned PR OS contour. Stage 3a patients (2) had resolved detachments without permanent sequelae. Stage 3b patients (9) had resolved detachments with marked PR OS and focal outer nuclear layer atrophy compared to both Stage 1 and normal retinas.

Conclusions:: Previous studies categorized CSCR patients into acute and chronic phases of disease, but to date, no staging methods have been described. Our findings suggest that it is possible to accurately and practically stage CSCR patients based upon clinical examination and UHR-OCT imaging. This ability may help in differentiating patients who require intervention to preserve vision from those who may be observed without treatment.

Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • imaging/image analysis: clinical • retina 
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