Evaluation of central serous chorioretinopathy with optical coherence tomography

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Abstract

PURPOSE:

To evaluate central serous chorioretinopathy with optical coherence tomography during the acute phase and after resolution of the acute phase.

METHODS:

In a prospective study, 23 consecutive eyes of 23 patients (19 men, four women; mean age ± SD, 46.0 ± 8.1 years; range, 29 to 60 years) with central serous chorioretinopathy were examined with optical coherence tomography during the acute phase and after resolution of the retinal detachment. After the initial examination, the patients were reexamined for 3 to 6 months (mean, 4.7 ± 1.1 months). Cross-sectional retinal images through the center of the fovea were obtained from all eyes by optical coherence tomography. The retinal thickness at the center of the fovea was measured. The difference between the retinal thickness during the acute phase and after resolution of the retinal detachment was statistically analyzed using the Wilcoxon test. We also examined a grayish-white lesion that corresponded to the leakage point in fluorescein angiography in four eyes.

RESULTS:

In the acute phase, neurosensory retina was thickened within the area of serous retinal detachment in all 23 eyes. The detached retina was thicker than the reattached retina after resolution of the retinal detachment in all eyes. The retinal thickness at the center of the fovea during the acute phase (range, 157 to 236 μm; mean ± SD, 196.9 ± 22.6 μm) was significantly thickened compared with that after resolution (range, 105 to 152 μm; mean ± SD, 124.8 ± 10.7 μm; P <.0001, Wilcoxon test). In the acute phase, areas of low reflectivity localized within the detached retina were observed in 18 of the 23 eyes. In the area of the grayish- white lesion, optical coherence tomography showed a moderately reflective mass bridging the detached neurosensory retina and retinal pigment epithelium in the four eyes; the outer layer of the detached retina was more highly reflective in these eyes. The retinal pigment epithelium was focally detached beneath the subretinal reflective mass in three of the four eyes.

CONCLUSIONS:

In all eyes studied, neurosensory retina was thickened within the area of serous retinal detachment in the acute phase of central serous chorioretinopathy. The grayish-white lesion seems to be a fibrinous exudate that accumulates in the subretinal space and infiltrates into the outer retina.

Section snippets

Patients and methods

We conducted a prospective study in 23 eyes of 23 consecutive patients (19 men, four women) with acute central serous chorioretinopathy within 8 weeks of the onset of subjective symptoms. All 23 patients had a serous retinal detachment that involved the center of the fovea; fluorescein angiography showed dye leakage from the retinal pigment epithelium. The patients’ ages ranged from 29 to 60 years (mean ± SD, 46.0 ± 8.1 years). In all 23 eyes, the optical coherence tomography images obtained

Results

Optical coherence tomography clearly demonstrated the configuration of the detached neurosensory retina and the retinal pigment epithelium. In all 23 eyes, the retinal detachment involved the center of the fovea. The subretinal space appeared to be optically clear. In the acute phase, the detached retina was thicker than the adjacent attached retina at the border of the serous retinal detachment in all 23 eyes (Figure 1, top left and right). Although areas of low reflectivity were seen in 18

Discussion

Optical coherence tomography showed that the retina was thickened where it was detached from the retinal pigment epithelium in all 23 eyes with central serous chorioretinopathy. The retinal thickness returned to normal when the subretinal fluid was absorbed. The detached retina showed intraretinal areas of low reflectivity in 18 of the 23 eyes. These tomographic features suggested that the detached retina swells in central serous chorioretinopathy. Slit-lamp examination with a fundus lens

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This work was supported by grants from the Ministry of Education, Science, and Culture of Japan, Tokyo, Japan.

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