Central Serous Chorioretinopathy Analyzed by Multimodal Imaging

Purpose: We correlated quantitative fundus autofluorescence (qAF) with other fundus features in patients exhibiting central serous chorioretinopathy (CSC). Methods: Short wavelength fundus autofluorescence (SW-AF, 488 nm excitation) was measured by qAF. Using nonnormalized images qAF values were calculated within eight concentric segments (qAF(8)) located at an eccentricity of 7 degrees to 9 degrees. Horizontal spectral domain optical coherence tomography (SD-OCT) scans and near-infrared fundus autofluorescence images (NIR-AF) were studied. Results: Thirty-six eyes of 20 patients (mean age 48.7 +/- 8.5 years) diagnosed with CSC were studied. Thirteen patients had bilateral disease; four patients were female. In 22 eyes CSC was present in the macula; in one eye the lesion was in a peripapillary location, 10 involved both locations, and three were unaffected. Serous retinal detachment, retinal pigmented epithelial detachment (PED), outer retinal atrophy and subRPE hypertransmission were all features identifiable by SD-OCT. NIR-AF images were helpful in detecting fovea! and parafoveal lesions. Sampling for retina-wide elevations in SWAF intensity by measuring qAF 8 did not indicate a generalizable relationship amongst CSC-diagnosed eyes. However, color-coded qAF images revealed alterations in SW-AF topography and intensity relative to healthy eyes at the same locations. Thus zones of higher than normal qAF intensity were found in association with SD-OCT detectable PED; loss of ellipsoid zone and interdigitation zone; and hyperreflectivity in outer retina. Pronounced decreases in qAF colocalized with serous retinal detachment and with outer retinal degeneration that included hypertransmission of SD-OCT signal into the choroid. Conclusions: Localized elevations in qAF reflect increased bisretinoid in association with CSC lesions. Translational Relevance: Foci of elevated qAF at some stages of CSC contribute to the natural history of the disease.

Automated summary

qAF was correlated with SD-OCT detectable features in CSC patients, while NIR-AF images were helpful in detecting lesions. Elevated qAF levels were associated with specific CSC-related abnormalities, indicating a potential role in disease progression.