AIM: To define the fundus autofluorescence(FAF)patterns in acute and chronic idiopathic central serous chorioretinopathy(ICSCR)and correlate them with fundus fluorescein angiography(FFA)findings.

METHODS: This is an observational case study in which we retrospectively reviewed the clinical data and FFA and FAF images of ICSCR patients and compared the findings.

RESULTS: The study included 25 eyes of 17 patients. We detected acute ICSCR in 5 eyes, and chronic disease or recurrence in chronic disease in 20 eyes. FAF images in acute cases showed a sharply delineated hypoautofluorescent spot in exactly the same location as the pinpoint leak detected on fluorescein angiography. In FFA images of chronic ICSCR diffuse areas of RPE atrophy are visualized as transmission fluorescence. FAF images demonstrate hypo-autofluorescence that corresponds in shape and location to the areas showing the most intense transmission fluorescence on FFA, whereas areas with less transmission fluorescence on FFA correspond to hyper-autofluorescence on FAF. The hypo-autofluorescent spot pointing to the site of RPE leakage cannot be localized as precisely as in acute cases.

CONCLUSION: FAF imaging in ICSCR is capable of depicting FAF patterns that are characteristic of various stages of the disease. It is a risk-free and reproducible alternative to fluorescein angiography in ICSCR.