[Pathophysiology of macular diseases--morphology and function].

Area of Science:

• Ophthalmic imaging techniques including enhanced depth imaging optical coherence tomography (EDI-OCT) and fundus autofluorescence (AF).
• Pathophysiology of retinal diseases such as central serous chorioretinopathy (CSC), Vogt-Koyanagi-Harada (VKH) disease, and macular detachment.
• Cellular mechanisms involving photoreceptor and retinal pigment epithelial (RPE) cells.

Context:

• Ophthalmic fundus imaging is crucial for understanding retinal disease pathophysiology.
• Macular diseases involve morphological changes in the choroid, subretinal space, and retinal cells.
• Existing imaging modalities provide insights but functional assessment requires further development.

Purpose:

• To investigate choroidal changes in macular diseases using EDI-OCT.
• To elucidate subretinal changes and RPE cell damage mechanisms in CSC.
• To develop and apply a novel method, autofluorescence densitometry (AFD), for assessing photoreceptor function.

Summary:

• EDI-OCT revealed increased choroidal thickness in CSC and VKH disease, with thickness changes correlating with treatment response (e.g., PDT, corticosteroids).
• Yellow deposits in CSC were associated with photoreceptor outer segment accumulation and RPE cell damage, evidenced by AF and OCT findings.
• AFD successfully quantified photopigment density, demonstrating functional outer retinal impairment in CSC, even with morphological recovery.

Impact:

• EDI-OCT aids in diagnosing and managing choroidal involvement in diseases like CSC and VKH.
• Understanding yellow deposit formation provides insights into CSC pathogenesis and RPE cell dysfunction.
• AFD offers a new, non-invasive method to evaluate outer retinal function, complementing structural imaging.