Background: Chronic presentations of central serous chorioretinopathy (CSC) may be associated with large serous retinal detachments and subretinal exudates. The exudates are believed to be fibrin in acute disease and lipid in chronic detachments. Fundus autofluorescence (FAF) imaging has been used to study lipofuscin within the retinal pigment epithelium (RPE) and the integrity of the RPE tissue layer.
Methods: FAF imaging results for two patients with chronic CSC and large dependent retinal detachments were evaluated.
Results: As the detachments resolved, subretinal precipitates emerged. They were initially hyperautofluorescent, indicating that they were not lipid, and evolved with normalization of the autofluorescence but no RPE atrophy.
Conclusion: The exudates beneath resolving chronic detachments are not lipid in nature, and they are not exclusively from lipofuscin. They are likely from fluorophores generated by detached photoreceptors and liberated into the subretinal space. These observations contribute to the knowledge of chronic CSC and the related visual prognosis.