Autofluorescence of the retinal pigment epithelium in patients with central serous chorioretinopathy

Purpose: The lack of histopathological material has placed limitations on o ur knowledge on lipofuscin in central serous chorioretinopathy (CSCR). This study was designed to document the pathological changes of the retinal pig ment epithelium (RPE) in CSCR using in vivo recording of fundus autofluores cence. Methods: Fundus autofluorescence was documented in 62 eyes of 44 subjects w ith CSCR using a laser scanning ophthalmoscope (Zeiss, Oberkochen; excitati on wavelength: 488 nm, barrier filter at 521 nm). Images were compared to t he respective fundus appearance and fluorescein angiograms. Results: Neurososensory retinal detachments showed diffuse increased autofl uorescence corresponding to the detached area. Long-standing lesions showed very irregular autofluorescence with regions greater and less than the bac kground levels of autofluorescence. Conclusion: Focal accumulation of autofluorescent material occurs at the le vel of the RPE in patients with CSCR, relating to variation in metabolic ac tivity of the RPE. This technique may be useful in selecting patients for l aser photocoagulation.