High-Resolution Optical Coherence Tomography Visualizes Posterior Vitreous Lamellar Architecture in Eyes With Chronic Central Serous Chorioretinopathy.

PURPOSE: High-resolution optical coherence tomography (HighRes-OCT) enables in vivo visualization of microstructural features that are not accessible with conventional clinical OCT systems. Using this capability, we investigated posterior vitreous microarchitecture in eyes with chronic central serous chorioretinopathy (CSC) and healthy individuals. METHODS: HighRes-OCT imaging (axial resolution approximately 3 µm) was performed in 20 patients with chronic CSC and 20 age-matched healthy subjects. Posterior vitreous structures were qualitatively assessed for the presence of discrete lamellar patterns and compared with conventional spectral-domain OCT (SD-OCT) acquired at the same visits. Lamellar visibility was evaluated across scan orientations, and reproducibility was assessed in all CSC eyes with follow-up imaging. RESULTS: Distinct hyper-reflective lamellar structures within the posterior vitreous were clearly identified in 9 of 20 CSC eyes, whereas no comparable lamellar organization was observed in healthy eyes. In CSC eyes, lamellae appeared as parallel, layered bands located immediately anterior to the internal limiting membrane and were reproducible across scan orientations. These structures were not readily discernible on conventional OCT. Healthy eyes showed relatively homogeneous vitreous reflectivity, although faint linear structures were occasionally observed. CONCLUSIONS: HighRes-OCT enables in vivo visualization of posterior vitreous lamellar microstructures that are not readily discernible with conventional clinical OCT. The preferential detection of these structures in eyes with chronic CSC suggests disease-associated alterations in vitreous matrix organization and highlights a previously underexplored dimension of vitreous imaging. TRANSLATIONAL RELEVANCE: Visualization of vitreous microarchitecture using HighRes-OCT may provide a new translational imaging window to study disease-related vitreous remodeling and its relationship to retinal pathology.