First Author: H.Fukuyama JAPAN
Co Author(s): Y. Komuku F. Gomi
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To examine the morphological characteristics of intraretinal fluid observed in central serous chorioretinopathy (CSC) from the tomographic and en face OCT images and to elucidate the association factors from the findings obtained from the other fundus imaging during the follow-up period.
This study was a retrospective case series conducted at the Sumitomo Hospital and Hyogo College of Medicine
This retrospective study included 16 eyes from 13 patients with CSC showing focal or diffuse retinal splitting. The distribution of retinal splitting was evaluated on enface images with swept source OCT (SS-OCT, Topcon, Tokyo, Japan). The B-scan OCT images, colour fundus photography, fluorescein and indocyanine green (ICG) angiography, and clinical course were also reviewed. The outer retinal splitting was defined as the presence of connectively arranged intraretinal optically clear spaces on B-scan and meshwork-like changes distributed mainly in the outer nuclear layer on enface OCT image.
Ten of 13 patients were male (76.9%) and ages ranged from 43-77 years (mean, 61.5 years). Submacular fluid and retinal splitting with or without cystoid retinal changes were confirmed on enface and B-scan OCT. The retinal splitting involved the papillomacular region in 13 eyes (81.3%), the macular region only in two eyes (12.5%) and the superior area to the macula in one eye. At least one fluorescein dye leakage site was seen within the area of retinal splitting in 13 eyes (81.3%) and 10 eyes had accompanying patchy RPE atrophy. In 6 eyes with retinal splitting at the papillomacular region, intense hyperfluorescence or leakage was seen at the temporal edge of the disc. No apparent relationship was observed between the area of retinal splitting and choroidal vascular hyperpermeability in ICGA. Thirteen eyes received treatment and complete resolution of retinal splitting was obtained in eight eyes together with the resolution of subretinal fluid.
Retinal splitting in eyes with submacular fluid associated with CSC was observed beyond the macula and frequently located in the papillomacular area on enface OCT. The region showing fluorescein leakage including patchy RPE atrophy and temporal margin of the disc was associated with the distribution of retinal splitting.