Characteristics of intraretinal deposits in acute central serous chorioretinopathy

Abstract

Purpose: To describe the temporal and spatial characteristics of intraretinal deposits in patients with acute central serous chorioretinopathy (CSC) using spectral domain optical coherence tomography (OCT).

Materials and methods: We retrospectively reviewed the medical records of all patients that presented with acute CSC to Weill Cornell Medical College from January 2012 to May 2013. Acute CSC was defined as a diagnosis of CSC within 4 months of the onset of symptoms. Only one eye per patient was included in the study. Each patient was imaged with spectral domain OCT at the initial office visit. The decision to reimage these patients was made by the treating physician.

Results: A total of 25 patients (25 eyes; 17 men and eight nonpregnant women) were included in this review. Seven of 25 patients (28%) demonstrated intraretinal deposits within the outer plexiform layer during the initial OCT, with deposits appearing as early as the same day as the onset of symptoms. A total of 25 of 25 patients (100%) demonstrated intraretinal deposits in the outer nuclear layer upon initial (76%) or follow-up OCT, as early as 2 days after the onset of symptoms. A total of 24 of 25 patients (96%) demonstrated deposits in the external limiting membrane upon a follow-up OCT, as early as 7 days from symptoms appearing. A total of 24 of 25 patients (96%) developed intraretinal deposits in the inner segment/outer segment layer upon follow-up OCT, appearing as early as 14 days after symptom onset. At the time of resolution of subretinal fluid, 20 of 25 patients (80%) demonstrated intraretinal deposits.

Conclusion: Intraretinal deposits are present in the outer retinal layers in patients with acute CSC, with the deposits appearing progressively deeper within the retina as the condition evolves. Upon resolution of subretinal fluid, the deposits slowly resolve.

Keywords: acute central serous chorioretinopathy; intraretinal deposits; spectral domain OCT.

Figure 1

Number of days plotted against the four main involved layers. The number of days is represented on the vertical axis; the horizontal axis shows the four layers. The square dots in the chart indicate the average (blue dots) and the standard deviation (red dots) of days since the onset of symptoms in which deposits showed up in one of the involved layers. The figure can help better understanding of the time progression of deposit through the layers. Abbreviations: OPL, outer plexiform layer; ONL, outer nuclear layer; ELM, external limiting membrane; IS/OS, inner segment/outer segment; SD, standard deviation.

Figure 2

(A and B) Optical coherence tomography of a patient (patient 1) with acute central serous chorioretinopathy, taken 2 days after the onset of symptoms. The red circles indicate intraretinal deposits (small white dots) inside the outer plexiform layer (A) and the outer nuclear layer (B).

Figure 3

Optical coherence tomography of a patient (patient 12) with acute central serous chorioretinopathy, taken 10 (A) and 15 days (B) after the onset of symptoms. The red circle and red arrows indicate intraretinal deposits (small white dots), respectively, inside the external limiting membrane (A) and the inner-segment/outer-segment junction (B). (B) The subretinal fluid is completely resolved, but some deposits are still present even after this resolution.