Morphological Changes of Retinal Pigment Epithelial Detachment in Central Serous Chorioretinopathy

Normal retinal tissue consists of the nine-layer sensory retina on the vitreous side and onelayer retinal pigment epithelium on the choroidal side. Serous retinal detachment is a detachment of the sensory retina from the retinal pigment epithelium. Central serous chorioretinopathy (CSC) is a condition causing local serous neurosensory detachment in the macular region. CSC causes circular or oval serous retinal detachment. Spectral domainoptical coherence tomography (SD-OCT) is a useful tool for detecting morphological changes. Spectralis® HRA+OCT (Spectralis Heidelberg retina angiograph optical coherence tomography) uses a super-luminescent diode as the light source, which has a central wavelength of 870 nm. Scanning an object with two different wavelengths allows simultaneous display of the confocal scanning laser ophthalmoscopy (cSLO) image and the OCT image of a chosen plane. Therefore, it is possible to visualize the OCT image of a lesion depicted on angiography (fluorescein angiography or indocyanine green angiography) in the same location. The angiographic image of the structure or the lesion depicted on the OCT image can both be observed. Using Spectralis® HRA+OCT, we performed fluorescein angiography, indocyanine green angiography and OCT during the clinical course of acute central serous chorioretinopathy. We studied in detail the state of the retinal pigment epithelium at the leakage point, and the relations of the leakage point to both pigment epithelial detachment and moderately to highly reflective substances.