Objective To observe ophthalmoscopic image characteristics of central serous chorioretinopathy (CSC). Methods Twenty-one eyes of the 18 patients diagnosed with CSC were enrolled in this study．The patients included 12 males (14 eyes) and six females (seven eyes)．The patients ages ranged from 26 to 47 years，with a mean age of (39.1plusmn;5.4) years. There were nine patients (11 eyes) with acute CSC, seven patients (seven eyes) with chronic CSC, and two patients (three eyes) with recurrent CSC. All the patients were examined using color fundus photography including infrared (IR), auto-fluorescence (AF), near infrared ray-auto-fluorescence (NIR-AF), fluorescein angiography (FA) and indocyanine green angiography (ICGA) photography. The ophthalmoscopic image characteristics of CSC were comparared. Results The circular serous retinal detachments of 21 eyes were depicted in color images of the ocular fundus, which in the IR showed the hypo-fluorescence. Ten eyes displayed mottled hyper-fluorescent spots associated with serous retinal detachments corresponding to the leakage points. The serous retinal detachments of 15 eyes in the AF images showed hypo-fluorescence, six eyes showed hyper-fluorescence. Fourteen eyes presented with hypo-or hyper-fluorescent spots corresponding to the leakage points, seven eyes presented without abnormal fluorescence corresponding to the leakage points. In addition, three eyes with acute CSC showed many scattered hyper-fluorescent spots, which showed hypo-fluorescence in the ICGA. The serous retinal detachment of 15 eyes exhibited hypo-fluorescence in the NIR-AF images, six eyes showed hyper-fluorescence. Fourteen eyes presented with hypo- or hyper-fluorescent spots corresponding to the leakage points, seven eyes presented without abnormal fluorescence corresponding to the leakage points. Twenty-one eyes in FA identified the leakage. Eight eyes showed regional choroidal delayed filling, 13 eyes exhibited regional choriocapillary dilatation during 1-5 minutes after injection of ICGA. During 1-5 minutes after injection of ICGA, six eyes showed more lesions than FA, three eyes showed obvious patchy hypo-fluorescence whereas the FA were normal. Conclusions CSC has its own characteristic fundus images in the IR, FA and NIR-A. FA is still the photographic method of choice, but ICGA can reveal lesions of the choroid in CSC. IR, FA and NIR-AF are not as good as FA and ICGA for detecting of leakage points.
Objective To observe the clinical features of acute zonal occult outer retinopathy (AZOOR).Methods Eighteen patients (18 eyes) with AZOOR were enrolled in this study. All the patients were examined for corrected visual acuity, fundus examination, visual field and electroretinography (ERG). For part of these patients, fluorescein angiography (FFA), optic coherence tomography (OCT), visual evoked potential (VEP) and multifocal ERG (mf-ERG) were performed. Clinical features were observed. Comparative analysis was performed on the electrophysiological results between affected eyes and fellow eyes. The consistency of OCT, visual field and mf-ERG results was investigated.Results The patients included three males and 15 females. All patients were unilateral involved. 16 eyes (88.9%) were myopia, two eyes (11.1%) were emmetropia. 11 eyes (61.1%) have normal fundus; single yellow-white punctuate lesion or old RPE lesion near macular were found in three eyes (16.7%); depigmented zones in temporal retina were found in four eyes (22.2%). All central visual field results were abnormal, but peripheral visual field results were normal. OCT findings included irregularity, absence or breaks of the photoreceptor inner segment/outer segment (IS/OS) junction. Amplitudes of full-field ERG were reduced in the affected eyes (t=3.516，2.689，3.103，3.517，2.999，3.309；P＜0.05), and implicit times were delayed in most responses except for rod response (t=1.023,P=0.306). Amplitudes of P100 wave of visual evoked potential were reduced statistically (t=2.04,P=0.041), but the differences of implicit times between the affected eyes and the fellow eyes were not statistically significant (t=1.687,P=0.092). Amplitude reduction of multifocal ERG existed in all affected eyes. Coincidence was found between results of OCT and mf-ERG. But abnormal zones found by central visual field did not always coincide with those by mf-ERG. Conclusions The majority of patients who develop AZOOR are young women with myopia. Most patients have normal fundus. Central visual field and electrophysiological examinations are always abnormal. Irregularity, absence or breaks of the photoreceptor IS/OS junction can be proved by OCT.
The improvement of diagnostic levels for fundus diseases depend on the advancements of fundus imaging technology. Different fundus imaging technologies allow doctors to inspect ocular fundus from different aspects such as morphological or functional changes of retina. As a basic fundus examination method, optical coherence tomography provides highresolution and crosssectional retinal images coupled with noninvasive advantages. Fully understanding of the advantages and disadvantages of each fundus imaging technique, appropriate choosing one or combining several imaging techniques, and optimizing diagnostic procedures for each fundus disease are crucial steps to improve our diagnostic levels of ocular fundus diseases.
Objective To observe the characteristics of spectraldomain optical coherence tomography (SD-OCT) and fundus autofluorescence (FAF) in acute and chronic central serous chorioretinopathy (CSC).Methods Seven-three eyes of 67 patients with CSC diagnosed by slit-lamp microscopy, fundus photochromy, fundus fluorescein angiography (FFA) and indocyanine green angiography were enrolled in this study. All the patients were examined for FAF and SD-OCT. The patients were divided into acute CSC group (37 patients, 37 eyes) and chronic CSC group (30 patients,36 eyes) according to the clinical features and FFA images. According to the OCT feature in retinal detachment area, they were divided into three categories, which including intact, non-intact and atrophy outer segment, respectively. According to the FAF characteristics, they were divided into hyper-FAF, hypo-FAF and mixed type, respectively. The characteristics of SD-OCT and FAF of both acute and chronic CSC patients were evaluated and analyzed. Results In acute CSC group, 19 eyes (51.35%) were hypo-FAF, 18 eyes (48.65%) were hyper-FAF. In chronic CSC group, two eyes (5.56%) were hypo-FAF, 16 eyes (44.44%) were hyper-FAF, and 18 eyes (50.00%) were mixed type. There was significant difference between both groups (chi;2=31.872,P=0.000). The SD-OCT results showed that in acute group, 15 eyes (40.54%) were intact outer segment, 18 eyes (48.65%) were non-intact outer segment, and four eyes (10.81%) were atrophy outer segment. In chronic group, five eyes (13.89%) were intact outer segment, 17 eyes (47.22%) were non-intact outer segment, and 14 eyes (38.89%) were atrophy outer segment. There was significant difference between both groups (chi;2=10.572,P=0.005). Conclusions The FAF characteristics of acute and chronic CSC mainly manifests hypo-FAF and mixed type, respectively. The OCT characteristics of acute CSC mainly manifests intact outer segment and non-intact outer segment, but non-intact outer segment and atrophy outer segment in chronic CSC.