Retinal Pigment Epithelium Reflectivity at Leakage Site on Spectral-Domain Optical Coherence Tomography in Acute Central Serous Chorioretinopathy.

PURPOSE: To study the reflectivity of the retinal pigment epithelium (RPE) at the leakage site in acute central serous chorioretinopathy (CSC). METHODS: Twenty-nine patients (24 males and 5 females, mean age 46.1 ± 11.0 years) were included. The mean relative RPE reflectivity and the difference between the maximum and minimum relative RPE reflectivity at the leakage site and control site were measured on cross-sectional optical coherence tomography (OCT) scans. In eyes with pinpoint leakage, cross-sectional OCT scans and corresponding reflectivity profile plots were reviewed by a masked grader for the presence of visible RPE defects and focal depression of relative RPE reflectivity at the leak. RESULTS: Twenty-one (61.7%) and 13 (38.2%) leaks showed pinpoint and diffuse leakage, respectively. The mean relative RPE reflectivity at the leakage site was statistically significantly higher than that of the control site (0.82 ± 0.09 and 0.79 ± 0.12, respectively, p=0.03) in eyes with pinpoint leakage as well as in eyes with diffuse leakage (0.81 ± 0.10 and 0.74 ± 0.13, respectively, p=0.01). The difference of relative RPE reflectivity was statistically significantly higher at the leakage site compared to control site (0.56 ± 0.20 and 0.41 ± 0.06, respectively, p=0.002) in eyes with pinpoint leakage, but not in eyes with diffuse leakage (0.46 ± 0.12 and 0.40 ± 0.07, respectively, p=0.16). On cross-sectional OCT scans visible RPE defects at pinpoint leakage were found in 10 out of 21 (47.6%) cases. Focal depressions of RPE reflectivity corresponding to presumed RPE defects were found in 18 out of 21 (85.7%) cases. CONCLUSION: Leakage in acute CSC is associated with significant local increase of RPE reflectivity.