Analysis of the Configuration of the Retinal Photoreceptor Layer in Resolved Central Serous Chorioretinopathy Patients by Using Adaptive Optics Scanning Laser Ophthalmoscopy

Abstract

Purpose: : To analyze the configuration of the retinal photoreceptor layer in resolved central serous chorioretinopathy (CSC) patients by using adaptive optics scanning laser ophthalmoscopy (AO-SLO) and to compare the features of this layer with the findings of spectral-domain optical coherence tomography (SD-OCT) and fluorescein angiography (FA).

Methods: : This observational case study included 9 eyes of 9 patients with resolved CSC. All eyes were examined by the original prototype of AO-SLO and SD-OCT, and 7 eyes were examined by FA. AO-SLO images were acquired from multiple locations in the macula, and a montage of the AO-SLO images was created by selecting the area of interest and generating each image to be included in the montage. The area of serous retinal detachment and the FA leakage points in the acute phase were compared with the abnormal areas on AO-SLO image. The thickness of the outer nuclear layer (ONL), photoreceptor inner segment, and outer segment were measured using SD-OCT.

Results: : Large dark regions (>10 cone cell size) were localized at the fovea and FA leakage points, while small patchy dark regions (2_5 cone cell size) were found scattered over the area of serous detachment in the acute phase. The mean cone densities at 0.5 and 1.0 mm from the center of the fovea were 15230 and 11450 cells/mm². The average area of serous detachment in the acute phase was 8.14(±SD 6.27) mm², while that of abnormal cone cell layer with large dark regions was 2.51(±SD 0.78) mm². Further, SD-OCT revealed that the thickness of the ONL was reduced at the regions of large cone cell defects.

Conclusions: : In resolved CSC cases, the abnormal changes in the photoreceptor layer occur predominantly at the fovea and FA leakage points. Dynamics of the subretinal fluid may have some association with the notable damage of photoreceptor cells at the fovea.

Keywords: imaging/image analysis: clinical • macula/fovea • photoreceptors