Choroidal features in flat irregular pigment epithelial detachment associated with Chronic central serous chorioretinopathy: Avascular versus vascularized.

Hooshang Faghihi,Nazanin Ebrahimiadib,Ahmad Mirshahi,Hassan Khojasteh,Alireza Mahmoudi,Mohammadreza Mehrabi Bahar,Elias Khalili Pour,Hamid Riazi-Esfahani,Alireza Khodabande,Fatemeh Bazvand,Kaveh Fadakar,Fariba Ghassemi,Pukhraj Rishi

doi:10.1371/journal.pone.0257763

Hooshang Faghihi, Nazanin Ebrahimiadib + Show 11 more

Open Access

https://doi.org/10.1371/journal.pone.0257763

Copy DOI

Abstract

PurposeTo investigate the differences in the choroidal biomarkers between two forms of flat irregular pigment epithelial detachment (FIPED): avascular (aFIPED) and vascularized (vFIPED) in eyes with chronic central serous chorioretinopathy (CSC).Materials and methodsEnhanced depth imaging optical coherence tomography (EDI-OCT) was done in eyes with FIPED correlated to chronic CSC, fellow eyes, and also in healthy eyes from gender- and age-matched subjects. Eyes with FIPED were classified into two subgroups based on optical coherence tomography angiography (OCTA) findings: vFIPED and aFIPED. Different choroidal biomarkers such as subfoveal choroidal thickness (SFCT), total choroidal area (TCA), and choroidal vascular index (CVI) were compared between the groups.ResultsForty-four eyes from 42 patients with chronic CSC and FIPED along with 40 eyes from 20 healthy subjects were included. OCTA identified vascularization in 14 eyes in the FIPED group (31.8%). Mean SFCT was higher in the FIPED group compared to two other groups (p = 0.005). In comparison to patients with aFIPED, patients with vFIPED had lower SFCT (p = 0.003) and higher CVI (p = 0.020) based on multivariate analysis.ConclusionsIt seems that measurement of CVI along with SFCT may help to differentiate aFIPED from vFIPED in patients with CSC. Further longitudinal studies would be required to confirm the clinical significance of these findings.

Highlights

The hallmark of the pachychoroid spectrum is choroidal vascular congestion and hyperpermeability which may be followed by focal changes in retinal pigment epithelium (RPE) such as pigment epithelial detachment (PED) [1].In the continuum of pachychoroid spectrum, central serous chorioretinopathy (CSC) can occur as serous detachment of the neurosensory retina which is frequently accompanied by PED [1,2]
In comparison to patients with avascular FIPED (aFIPED), patients with vascularized FIPED (vFIPED) had lower subfoveal choroidal thickness (SFCT) (p = 0.003) and higher choroidal vascular index (CVI) (p = 0.020) based on multivariate analysis. It seems that measurement of CVI along with SFCT may help to differentiate aFIPED from vFIPED in patients with CSC
The presence of serous macular detachment associated with pachychoroid (detected with Enhanced-depth imaging optical coherence tomography (EDI-OCT)) and choroidal vascular hyperpermeability revealed on indocyanine green angiography led to the diagnosis of CSCR

Summary

Materials and methods

Enhanced depth imaging optical coherence tomography (EDI-OCT) was done in eyes with FIPED correlated to chronic CSC, fellow eyes, and in healthy eyes from gender- and age-matched subjects. Eyes with FIPED were classified into two subgroups based on optical coherence tomography angiography (OCTA) findings: vFIPED and aFIPED. Different choroidal biomarkers such as subfoveal choroidal thickness (SFCT), total choroidal area (TCA), and choroidal vascular index (CVI) were compared between the groups

Results

Introduction

Discussion