Central Serous Chorioretinopathy Analyzed by Multimodal Imaging

Transl Vis Sci Technol. 2021 Jan 8;10(1):15. doi: 10.1167/tvst.10.1.15. eCollection 2021 Jan.

Abstract

Purpose: We correlated quantitative fundus autofluorescence (qAF) with other fundus features in patients exhibiting central serous chorioretinopathy (CSC).

Methods: Short wavelength fundus autofluorescence (SW-AF, 488 nm excitation) was measured by qAF. Using nonnormalized images qAF values were calculated within eight concentric segments (qAF8) located at an eccentricity of 7° to 9°. Horizontal spectral domain optical coherence tomography (SD-OCT) scans and near-infrared fundus autofluorescence images (NIR-AF) were studied.

Results: Thirty-six eyes of 20 patients (mean age 48.7± 8.5 years) diagnosed with CSC were studied. Thirteen patients had bilateral disease; four patients were female. In 22 eyes CSC was present in the macula; in one eye the lesion was in a peripapillary location, 10 involved both locations, and three were unaffected. Serous retinal detachment, retinal pigmented epithelial detachment (PED), outer retinal atrophy and subRPE hypertransmission were all features identifiable by SD-OCT. NIR-AF images were helpful in detecting foveal and parafoveal lesions. Sampling for retina-wide elevations in SW-AF intensity by measuring qAF8 did not indicate a generalizable relationship amongst CSC-diagnosed eyes. However, color-coded qAF images revealed alterations in SW-AF topography and intensity relative to healthy eyes at the same locations. Thus zones of higher than normal qAF intensity were found in association with SD-OCT detectable PED; loss of ellipsoid zone and interdigitation zone; and hyperreflectivity in outer retina. Pronounced decreases in qAF colocalized with serous retinal detachment and with outer retinal degeneration that included hypertransmission of SD-OCT signal into the choroid.

Conclusions: Localized elevations in qAF reflect increased bisretinoid in association with CSC lesions.

Translational relevance: Foci of elevated qAF at some stages of CSC contribute to the natural history of the disease.

Keywords: central serous chorioretinopathy; fundus autofluorescence; near infrared fundus autofluorescence; photoreceptor; quantitative fundus autofluorescence; retinal pigment epithelium; short-wavelength fundus autofluorescence; spectral domain optical coherence tomography.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Central Serous Chorioretinopathy* / diagnosis
  • Female
  • Fluorescein Angiography
  • Fundus Oculi
  • Humans
  • Middle Aged
  • Multimodal Imaging
  • Tomography, Optical Coherence