Original article
Time-Periodic Characteristics in the Morphology of Idiopathic Central Serous Chorioretinopathy Evaluated by Volume Scan Using Spectral-Domain Optical Coherence Tomography

https://doi.org/10.1016/j.ajo.2012.02.031Get rights and content

Purpose

To investigate the time-period characteristics associated with morphologic changes in idiopathic central serous chorioretinopathy (CSC) using volume scans acquired by spectral-domain optical coherence tomography (SD-OCT).

Design

Retrospective, observational, cross-sectional case series.

Methods

Patients underwent visual acuity measurements, fundus examinations, fluorescein angiography, indocyanine green angiography, and SD-OCT volume scans. Patients were classified into 5 categories—acute CSC, early chronic (EC) CSC, late chronic (LC) CSC, sequelae of CSC, or recurrent CSC—according to the chronicity and the recurrence. We investigated the relationship between our classification and the detailed morphologic changes of the retinal pigment epithelium and outer retina that were observed in the SD-OCT images.

Results

A total of 76 eyes from 75 patients were included in this study. Serous retinal detachment was relatively higher in acute CSC. Low to flat pigment epithelial detachments (PEDs) were most commonly observed in all stages of CSC, especially in LC CSC, but some semicircular PEDs were occasionally observed in eyes with acute or EC CSC. Retinal dragging with fibrin was most frequently observed in eyes that were in the early stage of acute CSC. A thickened posterior surface of the detached retina was most commonly observed in eyes with acute CSC, whereas a thinned posterior surface of the detached retina was observed in eyes with LC CSC. Hyperreflective dots and subretinal exudates were more commonly observed in eyes with EC and LC CSC than in eyes with acute CSC. In eyes with recurrent CSC, 2 different patterns of SD-OCT findings were observed; these patterns resembled those that were found in either acute CSC or LC CSC.

Conclusions

SD-OCT finding patterns in CSC eyes differ according to the chronicity and the recurrence of the disease. Detailed investigation of the retinal pigment epithelium and outer retina using SD-OCT could be useful for estimating the duration of CSC.

Section snippets

Patients

We retrospectively reviewed the medical records of patients with idiopathic CSC who were examined at the Hanyang University Hospital between October 1, 2008 and November 30, 2011. Data from 76 eyes of 75 patients were included in this study. All of the patients who were included had undergone comprehensive ophthalmic examinations, including FA, IA (F-10; Nidek, Gamagori, Japan), and SD-OCT. Optical coherence tomography (OCT) was performed using a 3D OCT-1000 or -2000 (Topcon, Tokyo, Japan) to

Results

Data from 76 eyes of 75 patients were included in this study; 24 eyes (24 patients) had acute CSC, 17 eyes (17 patients) had EC CSC, 14 eyes (14 patients) had LC CSC, 10 eyes (10 patients) had sequelae of CSC, and 11 eyes (10 patients) had recurrent CSC. The mean age of all of the patients who were included was 48.56 ± 8.57 years (range, 33–73 years), and there was no significant difference in the mean age between the different CSC classification groups (P = .072, ANOVA). Twelve of the patients

Discussion

The chronicity of CSC is usually determined based on the subjective recall of the patient, and no appropriate classification system for determining the temporal stage of CSC has been established. Instead, CSC is arbitrarily classified into 1 of 2 time stages, acute or chronic, according to a duration period of 3 or 6 months.6, 7, 8, 18 In this study, however, we divided CSC patients according to the chronicity of their symptoms to conduct a more detailed investigation of the temporal

In Seok Song, MD, graduated from Hanyang University College of Medicine, Seoul, Korea. He completed his residency in ophthalmology at Hanyang University Hospital, Seoul, Korea in 2012. His fields of interest are various vitreoretinal diseases, including cornea and external eye diseases.

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In Seok Song, MD, graduated from Hanyang University College of Medicine, Seoul, Korea. He completed his residency in ophthalmology at Hanyang University Hospital, Seoul, Korea in 2012. His fields of interest are various vitreoretinal diseases, including cornea and external eye diseases.

Byung Ro Lee, MD, PhD, is a Professor and Chair of the Department of Ophthalmology, Hanyang University in Seoul, Korea. Dr Lee obtained his MD (1986) and PhD (1998) in medicine from Hanyang University, Seoul, Korea. He completed his residency in ophthalmology at Hanyang University Hospital and his retina research fellowship at Doheny Eye Institute, University of Southern California (1996-1997). He served as a visiting scholar at Jacobs Retina Center, the University of California, San Diego (2006-2007). His clinical and research interest include novel diagnostic imaging techniques and image analysis of vitreoretinal structures, vitreoretinal surgery, and retinal pharmacology.

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