Abstract
Abstract: :
Purpose: In eyes with central serous chorioretinopathy (CSC), a grayish–white fibrinous lesion is occasionally present in the area of dye leakage on fluorescein angiography. The grayish–white lesion sometimes has a ring appearance where the center is thinner and more pellucid than the edges. To clarify the pathologic changes of the ring–shaped fibrinous lesion in CSC, we examined patients with fluorescein angiography and optical coherence tomography (OCT). Methods:In a prospective study, 13 consecutive eyes of 13 patients (12 men, one woman) with acute central serous chorioretinopathy within 8 weeks of the onset of subjective symptoms. All 13 patients had a serous retinal detachment that involved the center of the fovea and a ring–shaped fibrinous lesion. The patients’ ages ranged from 35 to 54 years (mean ± SD, 44 years ± 5.7 years). With OCT, the fundi were scanned on horizontal and vertical planes through the ring–shaped fibrinous lesion under a monitoring camera. Results: Fluorescein angiography demonstrated a profuse dye leakage from the choroid into the subretinal space at the center of the ring–shaped fibrinous lesion in the early–phase, followed by its extension and later staining of fibrinous lesion. In the area of grayish–white fibrinous lesion, OCT showed moderately or highly reflective masses that bridged the detached neurosensory retina and the retinal pigment epithelium in all 13 eyes. Because the area of pellucid core of the ring–shaped grayish–white lesion showed an optical clear space beneath the neurosensory retina, the subretinal reflective masses was separated on cross–sectional images in all 13 eyes. Pigment epithelial detachment (PED) was observed beneath the fibrinous lesion by OCT and fluorescein angiography in 7 of the 13 eyes. All 13 eyes showed resolution of fibrinous lesions spontaneously or by laser photocoagulation, and reattachment of the neurosensory retina during the follow–up period. Conclusions:The center of the ring–shaped grayish–white fibrinous lesion seems to be a route of the exudative fluid caused from the choroid into the subretinal space. The surrounding grayish–white area seems to be fibrinous exudates that accumulate in the subretinal space.
Keywords: imaging/image analysis: clinical • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • macula/fovea