The overlapping spectrum of flat irregular pigment epithelial detachment investigated by optical coherence tomography angiography

Pichi, Francesco; Morara, Mariachiara; Veronese, Chiara; Ciardella, Antonio P.

doi:10.1007/s10792-017-0547-x

Cited by 16 publications

(11 citation statements)

References 25 publications

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“…This sign has been previously described as a pathological feature in polypoidal choroidal vasculopathy and PEDs in pachychoroid diseases [14], representing the neovascular proliferation and exudation from the polyps [20]. Chug et al discussed the convergent mechanism of formation between CSC and polyps due to hyalinization of choroidal vessels, along with replacement of the smooth muscle component by amorphous pseudocollagenous tissue [14][15][16][17][18][19][20][21].…”

Section: Discussionmentioning

confidence: 96%

“…80% of eyes a hyperfluorescent plaque with surrounding areas of hypofluorescence was observed in the late phase of ICGA angiography; 20% of eyes exhibited an ICG hypofluorescent washout. However, the persistence or vanishing of choroidal staining is difficult to evaluate in the late stage angiograms in presence of RPE atrophy, as previously described [ 16 ]. No signs of leakage or choroidal polyps were evident on the mid or late stage angiograms.…”

Section: Discussionmentioning

confidence: 99%

“…Today, OCTA is able to complete the multimodal approach, especially in chronic CSC and pachychoroid diseases, where CNV is difficult to be detected by FA or ICGA [ 16 – 23 ]. In our study, the analysis with segmentation of the outer retina revealed the presence of pathological vascular networks in 80% of eyes in correspondence with the flat, irregular PEDs.…”

Section: Discussionmentioning

confidence: 99%

“…Few data are available in literature investigating CNV morphology and characteristics in CSC, in particular in cases with slight PED [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

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The morphology of choroidal neovascularization in chronic central serous chorioretinopathy presenting with flat, irregular pigment epithelium detachment

et al. 2021

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Purpose To evaluate morphological characteristics of choroidal neovascularization in chronic central serous chorioretinopathy (CSC) presenting with flat and irregular pigment epithelium detachment (FIPED) by means of innovative multimodal imaging. Methods In this observational cross-sectional study, we examined 10 consecutive patients affected by chronic CSC and FIPED using fluorescein angiography (FA), indocyanine-green angiography (ICGA) and optical coherence tomography angiography (OCTA). A qualitative analysis of the nature and characteristics of neovascular membrane was performed, combining available multimodal imaging and literature data. Results Multiple areas of retinal pigment epithelium alterations, macular hypo- and hyperpigmentation and atrophic areas were identified. Spectral domain OCT (SD-OCT) showed subretinal fluid in 80% of eyes and the ‘double layer sign’ in all patients. Late FA phases showed staining areas without leakage in all eyes; ICGA showed a hyperfluorescent plaque with surrounding hypofluorescence in 80% of patients. OCTA detected characteristic neovascular networks in the outer retina within the FIPEDs, classified as filamentous vessels with a pruned tree-like pattern in five eyes and a tangled pattern in three eyes. The choriocapillaris network showed dark areas in 80% of eyes and diffuse dark spots in all eyes. Conclusion Multimodal imaging completes clinical characterization of FIPEDs in chronic CSC. This study using OCTA technology describes the phenotype of hidden neovascular lesions in shape and morphology.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Few data are available in literature investigating CNV morphology and characteristics in CSC, in particular in cases with slight PED [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

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The morphology of choroidal neovascularization in chronic central serous chorioretinopathy presenting with flat, irregular pigment epithelium detachment

et al. 2021

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“…Our study results are generally in agreement with reports from previous studies that associated small, flat-irregular PEDs with chronic CSCR. 15,20–24 The overall prevalence of PED in CSCR has been reported between 53% and 100%; 22,25,26 however, most studies have not differentiated between PED types. Ersoz et al 22 reported, in one of the largest retrospective cohort studies in 811 patients, a PED prevalence of 83% concluding that its presence is frequently associated with a chronic rather than acute course and it was only recently that studies have demonstrated possible influence of the PED shape on the course of the disease.…”

Section: Discussionmentioning

confidence: 99%

The significance of pigment epithelial detachment in central serous chorioretinopathy

Chronopoulos¹,

Kakkassery

Strobel³

et al. 2020

European Journal of Ophthalmology

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Purpose: To investigate the significance of the presence and form of pigment epithelial detachment in the course of central serous chorioretinopathy as well as corticosteroid use as a risk in our patient cohort. Material and methods: Retrospective, single center study of central serous chorioretinopathy patients between January 2013 and January 2019 recording corticosteroid use prior to onset and presence and type of pigment epithelial detachment (flat-irregular, dome-shaped, none) in relationship to disease course. Results: We analyzed 53 eyes of 53 consecutive central serous chorioretinopathy patients treated in our department. Mean patient age was 53 ± 13 years. A flat-irregular pigment epithelial detachment was associated with either chronic or recurrent central serous chorioretinopathy, whereas the absence of a pigment epithelial detachment correlated positively with acute central serous chorioretinopathy (chi-square test, p < 0.05). Of the 53 patients, 10 reported corticosteroid use, 40 denied steroid use, and 3 patients failed to make a clear statement. Corticosteroid use was not correlated with the onset of central serous chorioretinopathy (Student’s t-test, p = 0.0001, chi-square test, p < 0.005). Conclusion: A small, flat-irregular pigment epithelial detachment could be a marker for chronic or recurrent central serous chorioretinopathy, whereas the absence of pigment epithelial detachment could favor acute central serous chorioretinopathy. Advanced imaging studies may provide more information on the exact characteristics and nature of pigment epithelial detachments. Corticosteroid use as possible disease trigger was not confirmed in this study.

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Pachychoroid disease: a new perspective on exudative maculopathy

Yanagi

2020

Jpn J Ophthalmol

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The overlapping spectrum of flat irregular pigment epithelial detachment investigated by optical coherence tomography angiography

Cited by 16 publications

References 25 publications

The morphology of choroidal neovascularization in chronic central serous chorioretinopathy presenting with flat, irregular pigment epithelium detachment

The morphology of choroidal neovascularization in chronic central serous chorioretinopathy presenting with flat, irregular pigment epithelium detachment

The significance of pigment epithelial detachment in central serous chorioretinopathy

Pachychoroid disease: a new perspective on exudative maculopathy

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