Central serous chorioretinopathy (CSCR) in its chronic form is associated with which OCT finding that best differentiates it from neovascular AMD on multimodal imaging?
- A Subretinal hyper-reflective material with disrupted ellipsoid zone and outer retinal atrophy without intraretinal fluid ✓
- B Type 2 choroidal neovascularization (CNV) above the RPE
- C Large drusen with geographic atrophy
- D Cotton-wool spots with cystoid macular edema
Correct answer: A. Subretinal hyper-reflective material with disrupted ellipsoid zone and outer retinal atrophy without intraretinal fluid
Explanation
Chronic CSCR (duration >3 months) on OCT characteristically shows subretinal hyper-reflective material (precipitates on RPE), outer retinal atrophy, ellipsoid zone disruption, and subretinal fluid extending over a wide area — without the intraretinal cystoid fluid typical of neovascular AMD. The choroid is typically thick (pachychoroid phenotype) on enhanced depth imaging OCT. Type 2 CNV is a feature of neovascular AMD; drusen and geographic atrophy occur in dry AMD. Chronic CSCR may develop secondary type 1 CNV at the RPE level.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.