Original article
Correlation Between Fundus Autofluorescence and Central Visual Function in Chronic Central Serous Chorioretinopathy

https://doi.org/10.1016/j.ajo.2014.12.023Get rights and content

Purpose

To find possible correlations between the morphologic macular changes revealed by fundus autofluorescence (FAF) and the functional parameters such as visual acuity and retinal sensitivity in patients with chronic central serous chorioretinopathy (CSC).

Design

Prospective, cross-sectional study.

Methods

Forty-six eyes (39 consecutive patients) with chronic CSC were studied with FAF and microperimetry (MP). Retinal sensitivity value maps were exactly superimposed over FAF images. The following microperimetric parameters were applied: central 10-degree visual field, 4-2-1 strategy, 61 stimulation spots, white monochromatic background, stimulation time 200 ms, stimulation spot size Goldmann III. A possible relationship between MP and FAF was investigated.

Results

Mean best-corrected visual acuity (BCVA) was 20/32 (median 20/25, range 20/20–20/200). BCVA was significantly correlated with FAF findings (Mann-Whitney test; P < .0001). A positive concordance between FAF and MP evaluation was also found (total concordance of 0.720 with a kappa of Cohen of 0.456). The hypo-autofluorescent areas showed decreased retinal sensitivity, while adjacent areas of increased FAF could be associated to both normal and decreased retinal sensitivity. Absolute scotoma, defined as 0 dB retinal sensitivity, corresponded with absence of autofluorescence.

Conclusions

Altered FAF in chronic CSC patients has a functional correlation quantified by microperimetry. This study confirms the impact of FAF changes on retinal sensitivity and their value to reflect the functional impairment in chronic CSC.

Section snippets

Subjects and Methods

This prospective cross-sectional study had approval by the local Institutional Review Board, Eye Hospital, Torino, Italy. The data collection complies with Italian law. An informed consent was obtained from all the patients, and all research and data collection complied with the Declaration of Helsinki.

We enrolled consecutive cases of chronic CSC seen at the retina department of our clinic between January 1, 2011 and May 31, 2012. Each patient had a documented history of CSC persisting for more

Results

This study included 46 eyes of 39 patients with chronic CSC. The mean age was 53.67 years (median 54, range 32–77 years). Thirty-two of 39 subjects (82.1%) were male, and 7 (17.9%) showed bilateral CSC. All eyes presented a history of CSC lasting for more than 6 months, and fundus biomicroscopy as well as OCT examination revealed signs of chronic CSC, in particular focal serous retinal detachment, RPE atrophy and photoreceptor loss, or intraretinal cystic degeneration in the macula, with a mean

Discussion

This study evaluated the possible correlation between morphologic and functional findings in chronic CSC using FAF and microperimetry.

Chronic CSC is characterized by areas of FAF modifications in the central macula. In particular, hypofluorescent areas correspond to atrophic RPE changes with lipofuscin missing, while hyper-autofluorescence is found in correspondence of accumulation of unphagocyted photoreceptor outer segments.9, 18, 33 Both these FAF changes were present in our case series.

Chiara M. Eandi, MD, PhD, is an Assistant Professor in the Eye Clinic of the Department of Surgical Science, at the University of Torino, Italy. She received her medical degree from the University of Torino in 1998. She completed her ophthalmology residency and obtained her PhD at the University of Torino, Italy. She completed a research fellowship in retinal diseases at the LuEsther T. Mertz Retina Research Center of Manhattan Eye, Ear and Throat Hospital, New York, US. Dr Eandi's clinical and

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    Chiara M. Eandi, MD, PhD, is an Assistant Professor in the Eye Clinic of the Department of Surgical Science, at the University of Torino, Italy. She received her medical degree from the University of Torino in 1998. She completed her ophthalmology residency and obtained her PhD at the University of Torino, Italy. She completed a research fellowship in retinal diseases at the LuEsther T. Mertz Retina Research Center of Manhattan Eye, Ear and Throat Hospital, New York, US. Dr Eandi's clinical and research interests include retina and vitreous diseases and imaging techniques. She has authored several publications in peer-reviewed journals.

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