Optical coherence tomography-assisted enhanced depth imaging of central serous chorioretinopathy

Purpose: To describe characteristics of central serous chorioretinopathy (CSC) imaged by optical coherence tomography-assisted enhanced depth imaging (EDI-OCT).

Methods: The prospective observational case series study consisted of patients with acute or chronic CSC. All subjects underwent fundus fluorescein angiography, indocyanine green angiography (ICGA), and EDI-OCT.

Results: The study included 68 eyes (68 patients) with 35 eyes showing signs of acute CSC. Mean subfoveal choroidal thickness, 478 ± 114 μm, was larger than the normative value from the beijing eye study 2011 (254 ± 107 μm) on the same ethnic group. In the hyperfluorescent ICGA areas, EDI-OCT revealed a thinning of the inner choroidal layers and enlargement of the underlying hyporeflective lumina in all eyes. the diameter of the hyporeflective lumina (mean: 330 ± 103 μm) was significantly (P < 0.001) associated with subfoveal choroidal thickness (correlation coefficient [r]: 0.68). An RPE detachment was detected in 36 (53%) eyes. A double-layer sign defined as an undulated RPE layer and intact underlying Bruch's membrane (seen in 51 [75%] eyes) was significantly (P = 0.025) more often in the chronic CSC group (29/33; 87%) than in the acute CSC group (22/35; 63%). Prevalence of an RPE microrip (8/68 [12%] eyes) did not differ (P = 0.14) between the chronic CSC group (6/33; 18%) and the acute CSC group (2/35; 5.7%).

Conclusions: CSC is characterized by a thinned inner choroidal layer and enlarged underlying hyporeflective choroidal lumina in all eyes, in addition to a dome-shaped RPE elevation, a double-layer sign of the RPE/Bruch's membrane complex, and RPE microrips in some eyes. EDI-OCT may be helpful in the diagnosis of CSC.