Faculty Bibliography

OBJECTIVE To compare the optical coherence tomography (OCT) features of acute central serous chorioretinopathy (CSC) versus neovascular age-related macular degeneration (AMD), and to determine if OCT features can distinguish between these two entities. METHODS A retrospective, observational study of 50 eyes with CSC and 50 eyes with neovascular AMD. Stratus OCT line scans (5 mm) were reviewed for presence of subretinal/intraretinal fluid and retinal pigment epithelium detachment. The height of the fluid and detachments were measured using the OCT manual callipers, and the morphology of the highly reflective line was described. RESULTS Intraretinal fluid (IRF), pigment epithelial detachment (PED), irregularities, thickening and attenuation of the highly reflective line were more often associated with AMD. When present, the PED was significantly greater in AMD than CSC. Patients with CSC were more likely to have subretinal fluid (SRF), and when present, the SRF height was significantly greater in CSC. Patients CSC also had more hypertrophic outer retinal changes on OCT compared with AMD. CONCLUSION Neovascular AMD and acute CSC have distinguishing features on OCT that may help clinicians to differentiate accurately between the two conditions primarily using OCT.

PURPOSE: To characterize changes in fluorophore metabolism during acute idiopathic maculopathy (AIM) using autofluorescence (AF) imaging. METHODS: AF imaging was performed during the clinical course of a 38-year-old man with AIM. RESULTS: AF imaging initially revealed distinct hypofluorescence corresponding to a clinical pattern of retinal pigment epithelium (RPE) hypopigmentation and a window defect seen on fluorescein angiography. This hypofluorescence essentially resolved within 1 week, but adjacent hyperfluorescent features persisted over the course of resolution of the macular detachment. Six weeks later, the patient reported complete resolution of the central scotoma, and fundus examination and optical coherence tomography revealed resolution of the detachment. AF revealed mild persistent nasal hyperfluorescence, but the overall reflectance was closer in quality to that of the noninvolved retina. CONCLUSION: AF features in AIM reveal an acute disruption of fluorophore metabolism that resolves fairly rapidly, consistent with the concept of AIM as a self-limited inflammatory process of the RPE.