The "scolex" sign" - A distinct hyperreflective foci on the wall of serous pigment epithelial detachments in central serous chorioretinopathy - MICRON Report Number Seven.

PURPOSE: To describe a novel Optical Coherence Tomography (OCT) finding called "scolex sign" in cases of central serous chorioretinopathy(CSCR).

METHODS: This retrospective multicenter study included CSCR patients with serous pigment epithelial detachments(PED) greater than 100µm, with or without subretinal fluid(SRF). Eyes showing a distinct hyperreflective focus on the PED wall(scolex sign) were analyzed. An equal number of age-matched controls with PEDs but without the scolex sign were included. Multimodal imaging data were reviewed. A subgroup analysis based on SRF status was also performed.

RESULTS: Of 291 eyes with large serous PEDs, 52 eyes exhibited the "scolex sign" and were compared to 52 age-matched controls. Baseline characteristics including gender, systemic comorbidities, best recorded visual acuity(BRVA) and OCT parameters were similar in both the groups. However eyes with "scolex" sign exhibited more number of central PEDs and shorter distance from foveal centre. On follow-up, eyes with "scolex" sign showed a higher rate of PED flattening and SRF resolution trended to be higher compared to controls.

CONCLUSION: The "scolex" sign represents a novel, benign OCT feature seen in a subset of CSCR cases. While not associated with poorer outcomes or adverse sequalae, it may reflect ongoing reparative changes, indicating a resolving stage of the disease.