Evolution of fundus autofluorescence patterns over time in patients with chronic central serous chorioretinopathy

Abstract

Purpose: To determine the evolution of fundus autofluorescence (FAF) patterns in chronic central serous chorioretinopathy (CSCR) over time. Methods: We retrospectively studied the changes in FAF patterns over time in 157 eyes of 112 patients with chronic CSCR using the Heidelberg Retina Angiography with a 488-nm excitation light and a 500-nm cutoff barrier filter. Results: The mean duration of follow-up was 37.2 months. The most common baseline pattern was that of granular hypoautofluorescence (51.0%). The earliest change in chronic CSCR is diffuse hyperautofluorescence and it occurs approximately 4 months after the reported first episode. The most common change observed at this stage is a change within areas of hyperautofluorescence where hyper-reflective dots appeared or disappeared. Change in FAF patterns from areas of hyperautofluorescence to hypoautofluorescence was slow. Only 25% of eyes showed such a change in pattern by 36 months. It takes an average of 24 months for granular hypoautofluorescent pattern to develop confluent hypoautofluorescence. There were no predictive patterns for the development of confluent CSCR. Conclusion: Fundus autofluorescence (FAF) changes in CSCR evolve very gradually and so is not a good outcome measure for clinical trials.