Optical coherence tomography evaluation of detached macula from rhegmatogenous retinal detachment and central serous chorioretinopathy.

PURPOSE

To compare structural changes using optical coherence tomography (OCT) and visual acuity (VA) loss in patients with shallow macula-off rhegmatogenous retinal detachment (RD) and central serous chorioretinopathy (CSC) involving the macula.

DESIGN

Retrospective, comparative observational study.

METHODS

Fifteen eyes with rhegmatogenous RD and 21 eyes with CSC with comparable height of macular detachment (< or = 550 microm) were evaluated retrospectively. All eyes were subjected to complete ophthalmologic examination, including OCT analysis, and were followed up until complete resolution of RD.

RESULTS

The mean height +/- standard deviation at the fovea was 290 +/- 153 microm in rhegmatogenous RD and 310 +/- 141 microm in CSC. Although the duration of symptoms was longer in CSC than in rhegmatogenous RD (35.0 +/- 38.0 days vs 8.3 +/- 8.0 days), initial (0.25 vs 0.64 logarithm of the minimum angle of resolution [logMAR] units; P = .001) and final VA (0.09 vs 0.49 logMAR units; P < .001) were significantly better in CSC. OCT analysis of rhegmatogenous RD showed intraretinal cyst formation, intraretinal separation, and undulation of outer detached retina in 10 (67%), nine (60%), and six (40%) eyes, respectively. Eyes with two or more preoperative structural changes had poorer initial VA than eyes with none or one structural change. In comparison, none of the 21 CSC eyes showed any of these changes (P < .001).

CONCLUSIONS

Compared with CSC, macula-involving rhegmatogenous RD resulted in more rapid visual loss, despite similar height of foveal detachment. Structural changes on OCT may be correlated with different levels of visual function in these two conditions.