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Idiopathic Central Serous Chorioretinopathy
M edical abstracts Andrew S. Gurwood, O.D.
Idiopathic Central Serous Chorioretinopathy Montero JA, Ruiz-Monero JM. Optical coherence tomography characterization of idiopathic central serous chorioretinopathy. Br J Ophthalmol 2005;89(5):562-4. Idiopathic central serous chorioretinopathy (ICSC) typically affects young men between 20 and 50 years of age. Until recently, the diagnosis of ICSC was often confirmed with fluorescein angiography (FA), showing serous detachment of the retinal pigment epithelium (RPE) and associated detachment of the overlaying retina and adjacent areas with classic smoke stack or ink blot patterns. Optical coherence topography (OCT) has allowed us to better understand the structural and characteristic changes of ICSC, comparing favorably to its fluorescein counterpart. OCT and FA were performed on 39 eyes from 36 consecutive patients with ICSC on the same day. Eleven patients had symp-
tomatic changes lasting more than 12 months representing the chronic form, 15 patients had an acute episode within 4 months, and 10 patients had more than 2 episodes. OCT scans were centered in the fovea using 6 radial scans, 6 mm long. The fast macular scan function was used. The scans were performed 3 times to verify reproducibility, and, when defects were detected, the scan was centered over that position to rule out artifacts and other disturbances. Retinal thickness in the macular region was also measured. The results of the OCT scans and FA were studied and compared. Two distinct OCT patterns were observed in patients with ICSC. One pattern showed an empty vaulted area separating the RPE from overlying retina and corresponded to fluorescein filled areas. A hyper-reflective line was seen and was believed to represent RPE scarring. In 35 of the 39 eyes, there was a small bulge protruding from the RPE. Angiographically, this bulge was interpreted as leakage. The second pattern was defined by a semicircular vaulted space under-
C O L O R
Andrew S. Gurwood, O.D.
neath the RPE with the overlying retina measuring thinner than normal. This pattern was only seen in cases of chronic ICSC and was later identified using FA as having RPE detachments. The researchers concluded that OCT is a new noninvasive technique for confirming the diagnosis and determining the stage, severity, and mechanism of ICSC. OCT reproducibility and correlation make the test a viable and potentially safer alternative to FA. Stephen Hess, O.D.
632 OPTOMETRY
VOLUME 76 / NUMBER 11 / NOVEMBER 2005
Idiopathic Central Serous Chorioretinopathy Montero JA, Ruiz-Monero JM. Optical coherence tomography characterization of idiopathic central serous chorioretinopathy. Br J Ophthalmol 2005;89(5):562-4. Idiopathic central serous chorioretinopathy (ICSC) typically affects young men between 20 and 50 years of age. Until recently, the diagnosis of ICSC was often confirmed with fluorescein angiography (FA), showing serous detachment of the retinal pigment epithelium (RPE) and associated detachment of the overlaying retina and adjacent areas with classic smoke stack or ink blot patterns. Optical coherence topography (OCT) has allowed us to better understand the structural and characteristic changes of ICSC, comparing favorably to its fluorescein counterpart. OCT and FA were performed on 39 eyes from 36 consecutive patients with ICSC on the same day. Eleven patients had symp-
tomatic changes lasting more than 12 months representing the chronic form, 15 patients had an acute episode within 4 months, and 10 patients had more than 2 episodes. OCT scans were centered in the fovea using 6 radial scans, 6 mm long. The fast macular scan function was used. The scans were performed 3 times to verify reproducibility, and, when defects were detected, the scan was centered over that position to rule out artifacts and other disturbances. Retinal thickness in the macular region was also measured. The results of the OCT scans and FA were studied and compared. Two distinct OCT patterns were observed in patients with ICSC. One pattern showed an empty vaulted area separating the RPE from overlying retina and corresponded to fluorescein filled areas. A hyper-reflective line was seen and was believed to represent RPE scarring. In 35 of the 39 eyes, there was a small bulge protruding from the RPE. Angiographically, this bulge was interpreted as leakage. The second pattern was defined by a semicircular vaulted space under-
C O L O R
Andrew S. Gurwood, O.D.
neath the RPE with the overlying retina measuring thinner than normal. This pattern was only seen in cases of chronic ICSC and was later identified using FA as having RPE detachments. The researchers concluded that OCT is a new noninvasive technique for confirming the diagnosis and determining the stage, severity, and mechanism of ICSC. OCT reproducibility and correlation make the test a viable and potentially safer alternative to FA. Stephen Hess, O.D.
632 OPTOMETRY
VOLUME 76 / NUMBER 11 / NOVEMBER 2005