Dear Sir,

We read with interest the article by J A Montero and J M Ruiz-Moreno on ‘Optical coherence tomography (OCT) characterization of idiopathic central serous chorioretinopathy (ICSC)’.[1] We agree that OCT may offer a new approach to the staging and knowledge of ICSC, and may help the understanding of the mechanisms of the disease.

In our personal experience of OCT evaluation of 56 eyes we observed that with-in first two weeks of onset of symptoms the OCT showed a neurosensory detachment of varied extent and height in all the eyes which authors refer as optically empty vaulted area under the neurosensory retina. A clearly demarcated dome shaped retinal pigment epithelium detachment (RPED) was seen in 40 eyes where as clinically it could be picked up in 24 eyes-only. Careful analysis of OCT scan revealed characteristic small bulges similar to what authors have described were seen protruding from RPE, in 16 eyes and it related to leaking spots on angiography. We also observed that pick up rate of these small bulges was enhanced if the OCT was performed immediately following fluorescein angiography.

OCT performed in the resolving stages of the disease showed either a complete resolution or a partial resolution of the neurosensory detachment with persisting RPEDs along with neurosensory thinning. Few eyes showed decreased height of RPEDs suggestive of collapsing RPEDs. Thus, we share the same view with the authors that OCT is a useful tool for diagnosis, monitoring and follow-up of patients with ICSC and offers valuable information for establishing a new classification for ICSC.

References

1. Montero JA, Ruiz-Moreno JM. Optical coherence tomography characterization of idiopathic central serous chorioretinopathy. Br J Ophthalmol 2005;89:562-564.