Correlation in acute CSCR between hyperreflectivity on the infrared image in optical coherence tomography and fluorescein angiography.

Abstract

To determine the association between hyperreflective area identified on the reference image (en-face image) in spectral domain optical coherence tomography (SD-OCT) scan and the leak on fluorescein angiography in patients with acute treatment naive central serous chorioretinopathy (CSCR). Retrospective, observational chart review. The reference image (en-face) image on SD OCT raster scan was examined for the presence of a hyperreflective spot and an attempt was made to correlate its location on the actual leak seen on FFA using anatomical landmarks as reference. Follow up was 6 months after CSCR resolution. Appropriate statistical analysis was made. Sixty-two patients (65 eyes; 49 males) with CSCR were identified of which 62/65 eyes (95.38%) showed the said correlation. The mean age was 31.24 years. The mean follow-up was 17.25 months. The mean BCVA at baseline was 0.28 logMAR. The mean final BCVA was 0.08. The hyperreflective spot noted on the infrared (reference) image correlated the most with the classic ink-blot leakage as well as the minimally enhancing/ill-defined leakage pattern. In 37/41 eyes, the area of hyperreflectivitiy correlated with the pigment epithelial detachment. The hyperreflective spot resolved in most patients who received photodynamic therapy but persisted in most patients who received eplerenone therapy. Persistent hyperreflectivity after subretinal fluid resolution appeared to correlate with persistent metamorphopsia and reduced contrast sensitivity in eyes with no subretinal fluid. We demonstrate an interesting correlation between the area of leak and the OCT reference image (en face) used to determine the level of the scan. The study looks at the potential applicability of a correlation between leaking areas on fundus fluorescein angiography and a hyperreflective area on the infrared image in optical coherence tomography (OCT) in patients with central serous chorioretinopathy (CSCR).