Infrared Fundus Autofluorescence and Central Serous Chorioretinopathy

PURPOSE. To investigate the findings of infrared fundus autofluorescence in eyes with central serous chorioretinopathy (CSC). METHODS. This study was an observational follow-up of 83 eyes of 80 consecutive patients with CSC recruited from a hospital referral practice. Infrared autofluorescence(IR-AF) findings and those of other clinical studies, including short-wave autofluorescence (SW-AF), fundus color photography, and optical coherence tomography were assessed. The IR-AF changes that appeared during the follow-up period were recorded. The relationship between IR- and SW-AF was analyzed by comparing the categories of focal autofluorescence (granular hyper-AF, granular hypo-AF, and mixed AF). The influence of final clinical findings on final best corrected visual acuity (BCVA) was analyzed. RESULTS. Twenty-three of 83 (27%) eyes showed granular hyper-IR-AF, whereas 53 (64%) eyes showed granular hyper-SW-AF. Most of the eyes with granular hyper-IR-AF (92%) showed granular hyper-SW-AF. On the contrary, the eyes with granular hyper-SW-AF showed various patterns of IR-AF. The deposits with hyper-IR-AF corresponding to hyper-SW-AF turned into hypo-IR-AF with hyper-SW-AF in four eyes. Final BCVA was significantly worse in eyes with granular hypo-IR-AF compared with the eyes without the findings (P = 0.035). CONCLUSIONS. Granular hyper-IR-AF from the deposits in CSC appeared concurrently with hyper-SW-AF. Granular hyper-IR-AF changed from hyperautofluorescence to hypoautofluorescence during the follow-up period. This change of IR-AF characteristics was different from that of SW-AF. The changes are attributable to the modification of melanin in the RPE. The authors speculate that the lipofuscin-like materials contribute to the characteristic changes of IR-AF through the modification of melanin in the RPE. (Invest Ophthalmol Vis Sci. 2010;51:4956-4962) DOI:10.1167/iovs.09-5009