Journal List > J Korean Ophthalmol Soc > v.50(9) > 1008362

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Park, Lee, Lee, and Oum: Fundus Autofluorescence in Acute and Chronic-recurrent Central Serous Chorioretinopathy
Original Article

J Korean Ophthalmol Soc 2009;50(9):1353-1358.

Published online: 7 September 2009

DOI: https://doi.org/10.3341/jkos.2009.50.10.1353

Fundus Autofluorescence in Acute and Chronic-recurrent Central Serous Chorioretinopathy

Young Min Park, MD, Mi Hyun Lee, MD, Ji Eun Lee, MD, Boo Sup Oum, MD

Department of Ophthalmology, College of Medicine, Pusan National University, Busan, Korea

Address reprint requests to Boo Sup Oum, MD Department of Ophthalmology, Pusan National University Hospital #10 Ami-dong 1-ga, Seo-gu, Busan 602-739, Korea Tel: 82-51-240-7326, Fax: 82-51-242-7341, E-mail: bsoum@pusan.ac.kr

Received 27 April 2009       Accepted 23 June 2009

Copyright © 2009 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The aim of this study was to evaluate the efficacy and potential value of fundus autofluorescence (FAF) in central serous chorioretinopathy (CSC).

Methods

FAF images were retrospectively evaluated in 122 eyes (119 patients) diagnosed with CSC by fluorescein angiography and OCT. Patients were classified into four groups (normal, mild, moderate, and intense) based on the intensity of FAF. We compared FAF patterns in acute and chronic-recurrent CSC and evaluated the differences in FAF according to the initial best corrected visual acuity (BCVA). We also assessed the differences in subretinal fluid resolution after laser photocoagulation among groups.

Results

In the chronic-recurrent group, a significant increase in FAF was observed compared to the acute group (p <0.001). The increase in initial visual acuity in the normal FAF group was statistically significant compared to the other groups (p <0.05). The difference in FAF between patients with acute and chronic-recurrent CSC was not significant. FAF imaging in CSC demonstrates different leakage patterns according to the course of the disease, but the changes in FAF did not correspond to the leakage patterns. In 51 eyes in the group without treatment and in 27 eyes of the focal treatment group, no significant difference was found in subretinal fluid resolution.

Conclusions

FAF could be a non-invasive tool for monitoring RPE changes in central serous chorioretinopathy. FAF imaging could predict recent or former CSC episodes, and this information could be used to predict long-term visual acuity.

Keywords: Autofluorescence, Central serous chorioretinopathy, RPE

References

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Figure 1.
Amount of fundus autofluorescece intensity change compared to background intensity.
jkos-50-1353f1.tif
Table 1.
Patient demographics
  Acute Chronic-recurrent p value
Number of eyes (patients, no.) 51 (50) 71 (69) >0.05
Age (years, average) 45.8±8.2 49.2±9.2 >0.05
Sex (M / F) 40 / 8 60 / 11 >0.05
Symptom duration (weeks, average) 2.3 59.0 <0.001
Visual acuity (LogMAR, average) 0.26±0.23 0.39±0.36 0.02
Leakage on FA (+, %) 45 (88.2%) 63 (88.7%)  
Leakage on FA (−, %) 6 (11.8%) 8 (11.3%)  
Treatment (eyes, %) 9 (25.5%) 29 (40.9%) 0.003
 Focal laser 9 (25.5%) 21 (29.7%)  
 Photodynamic therapy 0 8 (11.3%)  
Fundus autofluorescence (eyes, %)      
 Normal 29 (56.9%) 13 (18.3%)  
 Mild 10 (19.6%) 23 (32.4%) <0.001
 Moderate 9 (17.6%) 15 (21.1%) <0.001
 Intense 3 (5.9%) 20 (28.2%)  
Table 2.
Distribution of FAF characteristics in acute and chronic-recurrent CSC
FAF change at the leakage point Acute Chronic-recurrent
Decreased at leakage point 23 (51.2%) 32 (50.8%)
Normal 11 (24.4%) 20 (31.8%)
Increased at leakage point 11 (24.4%) 11 (17.46%)

p=0.39, Chi square.

Table 3.
Fundus autofluorescence and initial visual acuity
Fundus autofluorescence group Initial visual acuity (LogMAR) p value∗(compared to normal group)
Normal 0.21±0.21  
Mild 0.37±0.32 0.011
Moderate 0.44±0.39 0.017
Intense 0.42±0.33 0.015

∗ paired t-test, Fischer's exact test.

Table 4.
Distribution of Fundus autofluorescence characteristics according to the different leakage pattern
Fundus autofluorescence change at leakage point One ink dot Irregular hyperfluorescence Smoke stalk
Decrease 23 (53.48%) 29 (56.86%) 3 (21.43%)
No change 10 (23.26%) 12 (23.53%) 9 (64.28%)
Increase 10 (23.26%) 10 (19.61%) 2 (14.29%)
Total 43 51 14

p=0.052, Chi square.

Table 5.
The differences in subretinal fluid spontaneous resolution rate according to fundus autofluorescence group
Fundus autofluorescence group SRF change after 3 months of follow up
Decreased or Resolved {eyes (%)} Increased or sustained {eyes (%)}
Normal 14 (46.7) 6 (28.6)
Mild 7 (23.3) 6 (28.6)
Moderate 4 (13.3) 5 (23.8)
Intense 5 (16.7) 4 (19.0)
Total 30 21

∗ SRF=subretinal fluid; p=0.60, Chi-square.

Table 6.
The effect of focal laser photocoagulation in subretinal fluid resolution according to fundus autofluorescence group
Fundus autofluorescence group SRF change at 2 months after focal laser treatment
Decreased or Resolved {eyes (%)} Increased or sustained {eyes (%)}
Normal 3 (15.8) 1 (12.5)
Mild 5 (26.3) 3 (37.5)
Moderate 7 (36.8) 4 (50.0)
Intense 4 (21.1) 0 (00.0)
Total 19 8

∗ SRF=subretinal fluid; p=0.85, Ch-square.

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