Central serous chorioretinopathy produces macular pigment profile changes

Macular pigment (MP) is the collective name for three isomeric carotenoids: lutein, zeaxanthin, and meso-zeaxanthin. Macular pigment density is greatest in the central retina, peaking at the fovea and falling to negligible levels at 7 degrees of eccentricity from the fovea. Several studies have documented the interocular symmetry of MP optical density (MPOD) spatial distribution. The ongoing University of Missouri-St. Louis study uses a novel, customized heterochromatic flicker photometer to map the spatial distribution of MPOD up to 8 degrees of eccentricity relative to the fovea. Here, we report the MPOD measurements in a subject with resolved central serous chorioretinopathy (CSC) in the right eye.

Two subjects performed the full MPOD spatial mapping. The test subject (WK) had a history of central serous CSC of the right eye. The control subject (CP) had an unremarkable ocular health history. Comprehensive exams were performed on each subject including Cirrus optical coherence tomography imaging and fundus photographs. Subject CP showed highly symmetric interocular MPOD profiles at the fovea and 2, 4, and 6 degrees of eccentricity. Subject WK showed interocular asymmetry at the fovea and at 2 degrees with relative symmetry at 4 and 6 degrees. A paired sample t test identified nonsignificant interocular values for subject CP and statistically significant differences of at 2 degrees for subject WK.

We hypothesize that subject WK's interocular MPOD spatial distribution asymmetry resulted from his history of resolved CSC. This asymmetry is statistically significant at 2 degrees of retinal eccentricity and corresponds to the extent of retinal pigment epithelium changes observed on the fundus photographs. These findings suggest that MP and retinal pigment epithelium changes after a CSC episode are comparable in the area of the retina affected. These disruptions may also be measureable in other macular conditions in which the sensory retina is affected (e.g., cystoid macular edema and clinically significant macular edema).