Photoreceptor outer segment layer contributes to optical coherence tomography signal attenuation beneath neurosensory detachments

Purpose To establish the factors responsible for attenuation of the optical coherence tomography (OCT) signal beneath the neurosensory detachment (NSD). Methods We retrospectively reviewed 33 eyes with acute central serous chorioretinopathy. The thickness of the neurosensory retina, the thickness of the photoreceptor outer segment (PROS) layer, the height of the NSD, and the reflectivity of the underlying retinal pigment epithelium (RPE) were measured at selected points of B-scans exported from 6 x 6 mm OCT angiography protocols. The intensity of the flow signal was measured at the corresponding regions of the choriocapillaris slab. The correlation between the parameters of the NSD and both the reflectivity of underlying RPE and the intensity of the flow signal in the choriocapillaris was calculated. Results Correlation coefficients between RPE reflectivity and neurosensory retinal thickness, PROS layer thickness, and NSD height were -0.32, -0.64, and -0.25, respectively (p < 0.001). Correlation coefficients between the intensity of the flow signal and neurosensory retinal thickness, PROS layer thickness, and NSD height were -0.24 (p = 0.004), -0.52 (p < 0.001), and 0.13 (p = 0.13), respectively. Conclusion The thickness of the PROS layer is the most significant factor affecting OCT signal at the level of RPE and OCT angiography flow signal in the choriocapillaris beneath the NSD.

Automated summary

This study aimed to investigate the factors responsible for attenuation of the OCT signal beneath the neurosensory detachment. The results showed that the thickness of the photoreceptor outer segment (PROS) layer was the most significant factor affecting the signal.