Fluorescein-Angiographic Patterns in Patients with Central Serous Chorioretinopathy at the Initial Visit

Abstract

We reviewed the clinical records, color photographs and fluorescein angiograms of 106 eyes of 53 patients (44 men and 9 women) with central serous chorioretinopathy who had been followed up for 1 year or more. Their ages ranged from 20 to 59 years. One eye in each patient was involved at the initial visit. According to fluorescein-angiographic findings, the lesions were divided into smokestack pattern (13 eyes), ink blot appearance (33 eyes) and minimally enlarging spot (7 eyes). Most patients complained of central scotoma, and most patients had moderately decreased visual acuities at the initial visit, which improved after recovery. In particular, all 7 eyes with a minimally enlarging spot had a visual acuity of 0.8 or more at the initial visit; of these 6 eyes had 1.0 or more several weeks later. On fluorescein angiography, 49 eyes demonstrated 1 leaking spot and 4 eyes showed 2 spots. Of 57 leaking spots, 10 were observed in the foveola, 31 were noted in the fovea and 16 were found in the para- or perifovea. Of 13 smokestack patterns, 5 were found in the inferonasal area. The ink blot appearance and minimally enlarging spots were frequently found in the superonasal and superotemporal areas.

Role of Optical Coherence Tomography in Central Serous Chorioretinopathy

“…In our study the commonest presenting complaint was blurring of vision (43.75%), followed by metamorphopsia (31.25%), relative scotoma (18.75%) and micropsia (6.25%) (Table2). Yamda, [5] et al studied 53 patients of central serous chorioretinopathy and the commonest presenting complaint in their study was relative scotoma (58%), followed by blurring of vision (34%), metamorphopsia (18%), micropsia (13.2%) and xanthopsia (5.7%), which is approximately similar to our study except that we found blurring of vision as the most common complaint and no patient in our study complained of xanthopsia. In our study out of 48 patients 7 had chronic central serous chorioretinopathy (duration more than 3 months) and 41 patients had acute central serous chorioretinopathy (Duration less than 2 weeks).…”

“…1b) type of leak (Table-4). Yamda, [5] et al reported in their study, 62.2% inkblot type of leakage which is lower than our figure of 85.7% and 24.62% of smoke stack type which is higher than our figure of 14.28%. Majority of the eyes in our study (89.58%) showed a single leakage point, 8.33% eyes showed double leakage point and only one eye (1.785%) showed multiple leakage points.…”

Clinical Profile, Fundus Fluorescein Angiographic and Optical Coherence Tomographic Findings in Central Serous Chorioretinopathy

“…A Montero et al (5) made a study on 39 eyes and the mean visual acuity at baseline was 6/9 (range between 6/6 to 6/ 12) this is consistent with our study. Yameda et al (6) studied 106 eyes of 53 patients and the commonest complaint in their study was a central or paracentral scotoma (58.50%) followed by blurred vision (34%), metamorphopsia (18.90%), micropsia (13.20). Our study showed scotoma to be the second commonest complaint while rest of the symptomatology is quiet parallel to that in our study.…”

Review and update for central serous chorioretinopathy

“…Subretinal fluid moves downward under the influence of gravity, resulting in various shapes of sensory detachment such as tear, dumbbell, or flask [3,15,19,20]. Atrophic tract connecting posterior pole and inferior sensory detachment can be observed in some chronic cases, which can be more pronounced in FA and fundus autofluorescence (FAF) [21,32,33].…”

“…The most common leaking pattern is an 'ink blot' pattern described by an early hyperfluorescent spot that gradually enlarges. The second most common leaking pattern (7-25%) is a 'smoke stack appearance' which is formed when dye passes into the subretinal space and ascends vertically to highest points and spreads laterally like umbrella or mushroom configuration until the entire area of serous detachment is filled (Fig 1) [32,33]. In acute forms, most cases had a single leakage site, rarely two or more [34].…”