Punctate hyperfluorescent spots associated with central serous chorioretinopathy as seen on indocyanine green angiography.

PURPOSE: The purpose of this study was to examine indocyanine green angiography of eyes with central serous chorioretinopathy (CSC). METHODS: We retrospectively studied the medical records of 39 patients (41 eyes) with active CSC who were <50 years of age. All patients had undergone fluorescein angiography and indocyanine green angiography using a confocal laser scanning system. RESULTS: On indocyanine green angiography, most patients showed choroidal abnormalities, such as filling delay, venous dilation, subretinal leakage, or focal areas of hyperfluorescence, that were attributed to choroidal vascular hyperpermeability. In addition, punctate hyperfluorescent spots were seen in 38 of 41 eyes (93%) with active CSC and in 29 of 37 fellow eyes (78%); these spots were seen in the macular area and outside the vascular arcade or in peripapillary locations, and they often appeared as clusters of distinct spots. A cluster of punctate hyperfluorescent spots was seen on midphase indocyanine green angiography, and focal areas of hyperfluorescence often appeared to expand with time from these punctate hyperfluorescent spots. CONCLUSION: Focal areas of hyperpermeability in CSC may be derived from the leakage of tiny punctate spots in the inner choroid. Hyperpermeability of these lesions may be involved in the development of serous retinal detachment associated with CSC.