Topographic assessment of retinal pigment epithelium detachment in central serous chorioretinopathy by three-dimensional
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Topographic assessment of retinal pigment epithelium detachment in central serous chorioretinopathy by three-dimensional optical coherence tomography single-layer retinal pigment epithelium map Sandeep Saxena & Carsten H. Meyer & Shashi R. Sharma
Received: 20 November 2012 / Accepted: 17 January 2013 / Published online: 31 January 2013 # Springer Science+Business Media New York 2013
Abstract Purpose This study aims to compare the topographic distribution of retinal pigment epithelium detachment (PED) in central serous chorioretinopathy (CSC) on spectral domain optical coherence tomography (SD-OCT) single-layer retinal pigment epithelium (SL-RPE) map and fluorescein angiography for the first time. Methods Twenty-seven eyes of CSC with PEDs were studied retrospectively. Topographic distribution of PEDs was documented on 50° fluorescein angiography and SD-OCT SL-RPE map on macular cube 512×128. Results Quantity of PEDs ranged from 1 to 5 on SD-OCT SLRPE map macular cube 512×128 and corresponding macular cube area on 50° fluorescein angiography. Topographic distribution of PEDs on SL-RPE map matched with PEDs on fluorescein angiography in the corresponding macular cube area, in all the cases (interobserver correlation=0.9). Conclusion SD-OCT SL-RPE map is a noninvasive, threedimensional advanced tool for documentation of topographic assessment of PEDs and obviates the need of fluorescein angiography for monitoring CSC. Keywords Central serous chorioretinopathy . Spectral domain optical coherence tomography . Fluorescein S. Saxena : S. R. Sharma Retina Service, Department of Ophthalmology, King George’s Medical University, Lucknow, India C. H. Meyer Department of Ophthalmology, Pallas Klinik, Olten, Switzerland S. Saxena (*) Department of Ophthalmology, King George’s Medical University, Lucknow 226003, India e-mail: [email protected]
angiography . Single-layer retinal pigment epithelium map . Pigment epithelium detachment
Introduction Central serous chorioretinopathy (CSC) is characterized by the development of serous neurosensory retinal detachment at the posterior pole [1] and is mainly diagnosed by fluorescein angiography that shows one or multiple areas of leakage from the retinal pigment epithelium (RPE) seen as “expanding dot” or “smoke stack” sign [1, 2]. The diagnosis of CSC is primarily clinical, aided by fluorescein angiography and optical coherence tomography (OCT). Fluorescein angiography classically shows the leakage of dye from the choroid through a focal RPE defect and it is pooling in the subretinal space in acute CSC. The serous detachment of the RPE (PED) underlying the retinal detachment is variable in size and in some patients is impossible to detect without the aid of fluorescein angiography. Multiple PEDs may occur. Although PEDs are typically small, in some patients they may encompass a disk diameter or larger [1]. OCT is traditionally used to quantify the amount and extent of the subretinal fluid, demonstrate thickening of the neural retina, and is commonly used for monitoring during
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