Fundus Autofluorescence of Elongated Photoreceptor Outer Segments in Central Serous Chorioretinopathy

PURPOSE: To determine the origin of fundus autofluorescence (AF) patterns in central serous chorioretinopathy (CSC). DESIGN: Retrospective, observational case series. METHODS: We retrospectively studied 30 consecutive eyes of 30 patients with primary CSC using AF and spectral-domain optical coherence tomography (SD-OCT). We measured the AF using the Heidelberg Retina Angiograph with a 488-nn excitation light and a 500-nm cutoff barrier filter and compared the AF patterns with ophthalmoscopy and SD-OCT. RESULTS: We observed a patchy increased AF in the macular area in 22 eyes (73%), in which the length of the photoreceptor outer segment at the central fovea tended to be longer than the other eyes (P = .06). The punctate increased AF corresponded to the ophthalmoscopic precipitates in 17 eyes with precipitates. AF significantly (P = .017) decreased in eyes with a prominent serous retinal detachment (SRD). Eight eyes (27%) had increased AF in the inferior SRD. CONCLUSIONS: The patchy increased AF appears to originate from elongated rhotoreceptor outer segments in the detached retina. The autofluorescent fluorophores from the photoreceptor outer segments may be concentrated in precipitates or have settled into the inferior SRD. (Am J Ophthalmol 2011;151:617-623. (C) 2011 by Elsevier Inc. All rights reserved.)