Evaluation of central serous retinopathy with en face optical coherence tomography

Background: The diagnosis of idiopathic central serous retinopathy (CSR) is usually based on biomicroscopy and fluorescein angiography ( FA). The optical coherence tomography (OCT) ophthalmoscope produces en face OCT scans ( OCT C-scans) and provides additional information not readily available by conventional imaging techniques. The authors describe the characteristic features observed in patients with a clinical diagnosis of CSR using the OCT ophthalmoscope. Methods: 38 eyes with a clinical diagnosis of CSR, seen at the Academic Medical Centre ( Amsterdam, Netherlands) and the New York Eye and Ear Infirmary ( New York, USA) between August 2002 and March 2004, were evaluated with standard digital FA and scanned with the OCT ophthalmoscope. Results: Nine of 38 eyes had no serous neurosensory detachment ( inactive CSR) when scanned with the OCT ophthalmoscope. Characteristics for active CSR (n = 29) were large neurosensory detachment (23/ 29), subretinal hyper-reflective deposits (20/29), and pigment epithelial detachment (15/29). One third of the patients, either active or inactive, had multiple small pigment epithelial detachments located both within and outside the neurosensory detachment. Conclusion: The OCT ophthalmoscope provides complementary morphological information on patients with CSR. The presence of more diffuse retinal pigment epithelium (RPE) changes lends further support to the concept that CSR is a diffuse rather than localised RPE anomaly.