Optical Coherence Tomography May Help to Diagnose Central Serous Retinopathy

Clinicians may be able to diagnose central serous chorioretinopathy (CSC) using optical coherence tomography (OCT), according to a study in Optometry and Vision Science. This finding could allow OCT to replace the invasive, but commonly utilized industry standards of fundus fluorescein angiography and indocyanine green angiography.  

Researchers analyzed 62 eyes of 56 patients with CSC (mean age: 44.34 years, age range: 26-67 years, 41 men, 15 women) using OCT. They performed ophthalmic exams, fundus fluorescein angiography, and measured photoreceptor outer-segment (PROS) thickness above the pigment epithelium detachment (PED) coinciding with the leakage point for all participants. The investigators compared this measurement with the mean PROS thickness outside the PED in patients with acute CSC. In total, 53 eyes (85.48%) had acute CSC and 9 eyes (14.52%) had chronic CSC. 

OCT revealed a new feature of a high-reflection band located within the macular area of the serous retinal detachment. Of the 53 eyes with acute CSC, 51 eyes (96%) exhibited this manifestation. According to the researchers, “This finding can be used as an imaging feature to aid in the diagnosis of CSC.”

Investigators also noted PROS thickness above the retinal pigment epithelium layer protuberance coinciding with the leakage point was thinner compared with the area outside the leakage point in most eyes with acute CSC (64%). This measurement was 22.7±8.8 μm, which was significantly less than the mean PROS thickness outside the PED at 64.3±21.3 μm (P ≤.001). 

“As a noninvasive retinal examination technique, optical coherence tomography can demonstrate characteristics that aid the clinician in the differentiation of retinal, retinal pigment epithelium, and choroidal lesions in patients with acute and chronic central serous chorioretinopathy,” according to researchers. “These characteristics can also be used to monitor disease progression. In patients where fundus fluorescein angiography is contraindicated or unavailable, optical coherence tomography may be a valuable clinical alternative for clinicians.”

Study limitations include the relatively small number of patients with chronic CSC, and some peculiar structures in the macular area may have contributed to the high-reflection band phenomenon.   

Reference

Li Y, Jin P, Lu J, Ma L, Qin X. Analysis of Optical Coherence Tomography in Acute versus Chronic Central Serous Chorioretinopathy. Optom Vis Sci. 2022;99(3):267-273. doi:10.1097/OPX.0000000000001846