Purchase this article with an account.
Rabih Hage, Sarah Mrejen, Elise Philippakis, Ramin Tadayoni, Alain Gaudric; Flat irregular pigment epithelium detachment in chronic central serous chorioretinopathy. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3731. doi: https://doi.org/.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
The aim of this study was to determine the incidence of Flat Irregular Pigment Epithelium Detachment (FI PED) in patients with Chronic Central Serous Choroidopathy (CSC) and its possible association with Type 1 Choroidal New vessels (CNV)
Retrospective study of 110 patients with chronic CSC, examined using Fundus Autofluorescence (FAF), Indocyanine Green Angiography (ICGA) and Spectral domain OCT (SDOCT) at least once during their follow-up. The records of the 39 patients who presented a FI PED (54 eyes) were analyzed. The diagnosis of CNV or polypoidal choroidal vasculopathy (PCV) was based on the presence of sub or intraretinal hemorrhages, hard exudation, and multimodal macular imaging including early and late frames of SLO ICGA.
The mean patient age was 58.3 years, 74.4% were males, a serous retinal detachment (SRD) was present in the 54 eyes and the choroidal thickness was increased in all cases. FI PED was bilateral in 38.5% of eyes. In 42/54 eyes, FI PED was subfoveal, and it was extrafoveal in 12 cases. In 43/54 eyes, FI PED remained stable for many years without lesion extent (mean symptom duration: 15 years) or was not complicated or did not respond to a trial of anti-VEGF treatment. Eleven eyes with FI PED presented with additional characteristic findings or were highly suspected of type 1 CNV (8) or PCV (3) during their follow-up. In 8/11 cases, early frames of SLO ICGA showed the abnormal pattern of the CNV network. On ICGA, the late hyperfluorescence was less specific of CNV since it was also present in FI PED not suspected of neovascularization.
Flat irregular PED was frequently observed in a series of chronic CSC patients. It was caused by type 1 CNV, associated or not with PCV in only 20% of cases. The remaining 80% of cases had no complication during the follow-up. We can assume that these cases were not CNV or at least not active CNV and that they did not need a specific treatment. However, we cannot rule out a possible future evolution towards CNV with such a clinical picture.
This PDF is available to Subscribers Only