Subretinal hyperreflective material in central serous chorioretinopathy

Purpose: To describe the the appearance and behavior of subretinal hyperreflective material (SHRM) in eyes with central serous chorioretinopathy (CSCR). Methods: This retrospective study included 20 eyes of 20 patients with CSCR presenting with SHRM, defined as sub-retinal deposits that appear hyper-reflective on OCT The eyes underwent either laser (15 eyes) or observation (5 eyes). Optical coherence tomography and fundus fluorescein angiography (FFA) characteristics were analyzed at baseline and resolution of neurosensory detachment, which were then co-related with the visual acuity at resolution. Results: Improvement in vision was seen in 16 eyes. Ellipsoid zone damage (P = 0.03) and external limiting membrane (ELM) damage (P = 0.000) at resolution; diffuse retinal pigment epithelium (RPE) abnormalities on FFA (P = 0.04), and the presence of scar (P = 0.000), were associated with poor visual outcome in univariate analysis. ELM damage at resolution was statistically significant (P = 0.001) in multivariate analysis. Conclusion: CSCR with SHRM have a good visual prognosis. ELM damage at resolution corelates with a poor visual acuity at resolution.