[Morphologic changes in acute central serous chorioretinopathy evaluated by spectral domain optical coherence tomography].

Objective: To describe the pathologic changes of macular in acute central serous chorioretinopathy (CSC) using spectral domain optical coherence tomography (SD-OCT).

Methods: It was a retrospective case series study. This study included 29 eyes of 29 patients with CSC. The fundus examination was conducted followed by SD-OCT to observe foveal microstructure changes. We evaluated the correlation between the thickness of the outer nuclear layer (ONL), the length of photoreceptors and best-corrected visual acuity (BCVA).

Results: Serous retinal detachment was found in all 29 eyes with SD-OCT. There was no obvious morphology change in ONL, the thickness of ONL was (96.94 ± 23.72) µm and did not different from that in normal control eyes (104.15 ± 11.90) µm. The thickness of photoreceptors was uniform in 11 eyes (31.9%), uniform but with defects in 6 eyes (20.7%), uneven in 4 eyes (13.8%), protruding of outer segments (OS) was observed in 6 eyes (20.7%) and flaking OS in 2 eyes (6.9%). The length from external limiting membrane to the longest outer segment in CSC eyes was 84 (52 to 148) µm and was not statistically different from that in normal eyes (69 to 82)µm. Morphology changes of retinal pigment epithelium (RPE) were found in 25 eyes, including pigment epithelial detachment of RPE (PED) in 21 eyes (72.4%), small bulge of RPE in 10 eyes (34.5%), granular deposition epi-RPE in 6 eyes (20.7%), defects of RPE in 3 eyes (10.3%). Fluorescein angiography (FA) was performed in 5 eyes and bulging RPE detected by SD-OCT seemed to correspond precisely to the leakage point on FA in 3 eyes. Age, course of disease and thickness of the ONL did not influence BCVA (logMAR). Uneven of thickness of OS was negative prognostic factors for BCVA (r = 0.382, P = 0.026).

Conclusions: SD-OCT can demonstrate finer pathologic changes in acute CSC. Furthermore, 3-D image allows localization of these pathologic features to specific site using ELM line as landmark. SD-OCT is a valuable tool for the diagnosis and for predicting visual recovery in CSC.