Apical atrophy of retinal pigment epithelial detachments in central serous chorioretinopathy.

To describe a presumed precursor stage of central serous chorioretinopathy (CSC).Two patients were identified during follow-up study of patients with CSC or CSC-related conditions. Two patients first seen with retinal pigment epithelial detachment subsequently developed findings compatible with CSC.A juxtafoveal retinal pigment epithelial detachment with apical atrophy of the retinal pigment epithelium with corresponding severe attenuation of the pigmentation of the retinal pigment epithelium was observed in both patients. One of the patients presented with a serous neurosensory retinal detachment with smokestack leakage 7 years after first being seen. The other patient was never seen with a neurosensory detachment.Isolated pigment epithelial detachment with apical retinal pigment epithelial atrophy may represent a precursor stage of CSC.