Focal retinal pigment epithelium breaks in central serous chorioretinopathy.

Purpose: To describe new evidence supporting a theory on the etiology of the focal retinal pigment epithelium (RPE) leak in central serous chorioretinopathy (CSC).

Methods: The records of two patients with CSC were reviewed, including examination details and results of fluorescein angiography, fundus autofluorescence imaging, and optical coherence tomography (OCT).

Results: A defect in the RPE monolayer demonstrated with OCT that corresponded to the site of the focal leak shown by fluorescein angiography was found in both patients.

Conclusion: The focal leak shown by fluorescein angiography in patients with active CSC is caused by an RPE defect in at least some cases. This finding supports a previously reported theory on the pathogenesis of CSC.