Abstract
Purpose :
Choroidal vascular hyperpermeability (CVH) on indocyanine green angiography (ICGA) is a hallmark feature of central serous chorioretinopathy (CSC). In this report, we describe three distinct patterns of CVH: uni-focal indistinct signs of choroidal hyperpermeability (uni-FISH) showing only one area of CVH, a multi-focal hyperpermeability phenotype (multi-FISH) showing multiple areas of CVH, and diffuse hyperpermeability (DISH) covering most of the posterior pole. This report assesses the distribution of these phenotypes and their association with various clinical characteristics in CSC.
Methods :
The CERTAIN study is a monocentric, retrospective study on consecutive CSC patients who were referred to a large tertiary referral center between 01/09/2021 and 30/11/2022 and underwent ultra-widefield (UWF) and 55° ICGA in addition to extensive multimodal imaging. Two independent graders assessed CVH patterns based on mid- to late-phase UWF and 55° ICGA separately. A third grader served as a referee in case of disagreement. Main outcome measures were the distribution of uni-FISH, multi-FISH, and DISH based on UWF and 55° ICGA and correlation to signs of CSC disease chronicity.
Results :
In total, 167 eyes of 91 patients were included in this study. Based on UWF ICGA, 43 (26%) showed uni-FISH, 87 (52%) multi-FISH, and 34 (20%) showed DISH. Median age (uni-FISH: 40 years, multi-FISH: 45 years, DISH: 57 years; p < 0.001) and logarithm of Minimum Angle of Resolution visual acuity (0 vs. 0 vs. 0.1, p < 0.001) differed significantly between these groups, as did the percentages of patients showing posterior cystoid retinal degeneration (PCRD; 0% vs. 1% vs. 18%, p < 0.001) or diffuse atrophic retinal pigment epithelial alterations (DARA; 0% vs. 17% vs. 29%, p < 0.001). Similar associations were observed when grading was based on 55° ICGA.
Conclusions :
The CVH patterns of uni-FISH, multi-FISH, and DISH are typical of CSC. These patterns correlate with established signs of CSC chronicity. Their predictive role in treatment response and prognosis remains to be evaluated.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.