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Jason Y. Zhang, Caio V. Regatieri, Ahmad A. Alwassia, James G. Fujimoto, Jay S. Duker; Micro-structural Features of Active Acute & Chronic Central Serous Chorioretinopathy On Spectral Domain Optical Coherence Tomography and Correlations with Autofluorescence Imaging. Invest. Ophthalmol. Vis. Sci. 2012;53(14):828.
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© ARVO (1962-2015); The Authors (2016-present)
To characterize micro-structural features of active acute and chronic central serous chorioretinopathy (CSCR) using high-resolution 2-dimensional (2D) line scan and 3-dimensional (3D) macular cube scans of spectral domain optical coherence tomography (SDOCT), and to correlate CSCR features on OCT with features noted on fundus autofluorescence (FAF).
A retrospective, observational study of 45 eyes from thirty patients with CSCR. SDOCT single-line 2D raster scans and 3D macular cube scans were reviewed for presence of retinal pigment epithelial detachment (RPED), sub-retinal fluid (SRF), disruptions in the inner segment/outer segment (IS/OS) junction or external limiting membrane (ELM), photoreceptor cell layer attenuation, and thickening of the retinal pigment epithelium (RPE). Correlational analysis was performed between fundus autofluorescence (FAF) and SDOCT images when FAF was available.
Using SDOCT 3D macular cube scans, 33 of 45 eyes (73.3%) during the active phase of acute or chronic CSCR showed presence of one or more RPEDs (in 10/13 acute CSCR eyes (76.9%) and 23/32 chronic CSCR eyes (71.8%)). Disruption of the IS/OS junction and ELM was visualized in 24 of 45 eye (53.3%) and 5 of 45 eyes (10%) respectively, as well as attenuation of the photoreceptor layer in 29 of 45 eyes (63.3%) and thickening of the RPE in 8 of 45 eyes (16.7%). In 26 eyes with follow-up scans, recovery of the photoreceptor layer architecture was detected in 18/26 eyes (68.8%), with SRF resolution in 11/26 eyes (43.8%). On follow-up, 8/26 eyes (31.3%) with initial RPEDs showed complete RPED resolution on OCT. In 16/17 eyes (92.3%) who underwent FAF with SDOCT imaging, there was a clear correlation between regions of SRF leakage and RPE changes on SDOCT with regions of hyper-autofluorescence and hypo-autofluorescence on FAF.
SDOCT can be used to characterize micro-structural features of CSCR such as RPED, SRF, changes in the IS/OS junction, ELM, and RPE. The 3D macular cube scan enables traversal of the entire set of B-scans to quickly assess for structural changes such as RPEDs which might not have been observed on a single-line scan. In addition, enhanced visualization of CSCR features on SDOCT allows for reliable correlation of OCT findings (i.e. presence of SRF and RPE changes) with regions of autofluorescence changes on FAF.
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