Three-dimensional Imaging of the Foveal Photoreceptor Layer in Central Serous Chorioretinopathy Using High-speed Optical Coherence Tomography

Objective To describe the 3-dimensional (3-D) imaging of the pathologic changes in the foveal photoreceptor layer in eyes with central serous chorioretinopathy (CSC) using high-speed optical coherence tomography (OCT). Design Prospective observational case series. Participants Twenty-seven eyes of 27 consecutive patients with various stages of CSC. Methods A prototype high-speed OCT system was fabricated for patient examinations based on Fourier domain OCT. The system had a sensitivity of 98 dB, a tissue axial resolution of 4.3 μm, and an acquisition rate of approximately 18 700 axial scans per second. Three-dimensional imaging was performed based on a raster-scan protocol. Main Outcome Measures Anatomic features of CSC distinguished by 3-D OCT. Results A line corresponding to backreflection from the external limiting membrane (ELM) was visible in images from eyes with all stages of CSC, including 6 in the acute, 5 in the chronic, and 9 in the recurrent phase of retinal detachment and 11 examined in the quiescent phase (including 4 reexamined after reattachment). Backreflection from the photoreceptor inner and outer segment junction (IS/OS) was missing before but present after reattachment. The ELM line bordered the photoreceptor nuclear and inner segment layers, clearly showing that CSC primarily alters the outer segment (OS) layer. Punctate areas of intense reflectivity were observed more frequently in the OS layer of detached retinas in cases of chronic or recurrent versus acute CSC ( P