The foveal photoreceptor layer and visual acuity loss in central serous chorioretinopathy.

Purpose: To describe changes of the foveal photoreceptor layer using optical coherence tomography (OCT) in central serous chorioretinopathy (CSC) and evaluate the correlation with visual acuity (VA) loss.

Design: Observational case series.

Methods: We studied 28 eyes with acute or chronic CSC using high-resolution OCT. The tomographic findings of the detached foveal photoreceptor layer were compared with VA. Sixteen eyes also were evaluated after foveal reattachment.

Results: The outer photoreceptor layer (OPL) in the detached fovea was preserved in 14 eyes, of which 13 had symptoms for <1 year and atrophic in 14 eyes with symptoms for >1 year. The preserved OPL had an even profile in 7 eyes and a granulated profile in 7 eyes. Mean VA was 0.19 logMAR with a preserved OPL and 0.72 logMAR with an atrophic OPL (P <.001). Cases seen after the detachment resolved included 6 eyes with preserved even OPL, 5 eyes with preserved granulated OPL, and 5 eyes with atrophic OPL. Mean final VA was 0.06 logMAR in eyes with preserved OPL and 0.90 logMAR in eyes with atrophic OPL (P <.001). The VA improved in 73% of eyes with preserved OPL and no eyes with atrophic OPL (P = .025). The VA recovered completely in 83% of eyes with preserved even OPL and no eyes with preserved granulated OPL (P = .015).

Conclusion: High-resolution OCT demonstrates changes in the foveal photoreceptor layer in CSC that highly correlate with VA loss and may predict visual recovery after macular reattachment.