Study of Subretinal Exudation and Consequent Changes in Acute Central Serous Chorioretinopathy by Optical Coherence Tomography

Abstract

To investigate the characteristics of subretinal exudation and consequent morphologic changes in acute central serous chorioretinopathy (CSC) using spectral-domain optical coherence tomography (OCT). Prospective, observational, cross-sectional case series. Patients with CSC with symptom duration of fewer than 3 months underwent visual acuity measurement, fundus observation and spectral-domain OCT examinations and then were evaluated for subretinal exudation and other changes. A total of 123 patients (123 eyes) were included, all showing various retinal pigment epithelium (RPE) abnormalities on OCT. OCT also showed subretinal exudation (65 eyes, 52.8%); retinal dipping (14 eyes, 11.4%); and photoreceptor layer defects (88 eyes, 71.5%). Without exception, the locations of these pathologic changes were closely related to the abnormal sites in the RPE. Those with subretinal exudation showed shorter durations of symptoms, whereas those with photoreceptor layer defects showed longer durations. In most eyes with retinal dipping, exudation connected it to RPE abnormalities. The defects of the photoreceptor layer, which involved the photoreceptor outer segment in 68 eyes, the photoreceptor inner segment in 20 eyes, and the outer nuclear layer as well, were likely to be the consequence of retinal dipping. OCT findings suggested that in eyes with acute CSC subretinal exudation, which indicated fibrin leakage through the RPE defects, might cause retinal dipping, thus leading to photoreceptor layer defects, and that spectral-domain OCT could provide a better understanding of the pathologic changes in acute CSC.