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Topography-guided identification of leakage point in central serous chorioretinopathy: a base for fluorescein angiography-free focal laser photocoagulation
  1. Dmitrii S Maltsev1,
  2. Alexei N Kulikov1,
  3. Jay Chhablani2
  1. 1 Department of Ophthalmology, Military Medical Academy, St Petersburg, Russia
  2. 2 Smt. Kanuri Santhamma Retina Vitreous Centre, L V Prasad Eye Institute, Hyderabad, Andhra Pradesh, India
  1. Correspondence to Dr Dmitrii S Maltsev, Department of Ophthalmology, Military Medical Academy, St Petersburg 194044, Russia;{at}


Purpose To identify optical coherence tomography (OCT) findings associated with the leakage points in patients with central serous chorioretinopathy (CSC) to provide fluorescein angiography (FA)-free focal laser photocoagulation (FLP) of the leakage point.

Methods A retrospective study included 48 patients with CSC (48 eyes). Colocalisation of leakage points with pigment epithelial detachments (PEDs) and with areas of photoreceptor outer segments (PROS) layer thinning was evaluated with OCT. Using FA for each leakage point, the relationship to neurosensory detachment was evaluated with retro-mode confocal scanning laser ophthalmoscopy.

Results Coincidence with PED was found in 52 of 65 (80.0%) leakage points. The PROS thinning was found in 47 of 52 (90.4%) of the PEDs coincided with leakage point. The mean distance from the upper border of neurosensory detachment to the leakage point was 27.3%±13.0% of the vertical dimension of the neurosensory detachment.

Conclusion This study demonstrates that PEDs localised in the upper half of the neurosensory detachment area and associated with the PROS thinning area coincided with the leakage point in a significant number of patients with CSC. The patients with non-resolving CSC with a small single PED localising in the upper one-third to one-half of the neurosensory detachment area with an area of PROS thinning above this PED may undergo FA-free OCT-guided FLP treating whole PED.

  • choroid
  • imaging
  • macula
  • retina

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  • Contributors DSM, ANK and JC designed the study. DSM and ANK collected the data. DSM and JC analysed the data. DSM and JC drafted the manuscript. DSM, ANK and JC critically reviewed and approved the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The Ethics Committee of Military Medical Academy.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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