Risk factors for flat irregular pigment epithelial detachment in chronic central serous chorioretinopathy and its association with choroidal neovascularization_Chinese Journal of Ocular Fundus Diseases

Authors：

Xie Kunpeng ^1,2 , Liu Pei ¹ , An Guangqi ¹ , Li Shu ¹ , Lu Chenyu ¹ , Du Liping ^1,2 ,  Jin Xuemin ^1,2

1. Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Henan Provincial Eye Hospital, Zhengzhou University School of Medical Sciences, Zhengzhou 450003, China;
2. Institute of Fundus Diseases, Zhengzhou University, Zhengzhou 450000, China;

Corresponding?author：

Jin Xuemin, Email: 2740913223@qq.com

Keywords：

Central serous chorioretinopathy; Flat irregular pigment epithelial detachment; Swept-source optical coherence tomography; Choroidal neovascularization

DOI：

10.3760/cma.j.cn511434-20250528-00236

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Objective To investigate the imaging characteristics of flat irregular pigment epithelial detachment (FIPED) in eyes with central serous chorioretinopathy (CSC), identify factors associated with its presence, and evaluate its association with choroidal neovascularization (CNV). Methods A retrospective clinical study. From March 2021 to May 2025, 206 patients (211 eyes) with CSC diagnosed at the Department of Ophthalmology of The First Affiliated Hospital of Zhengzhou University were included in the study. Eyes were divided into a FIPED group and a non-FIPED group, and the FIPED group was further subdivided into acute CSC (aCSC) and chronic CSC (cCSC) subgroups according to disease duration. All eyes underwent best-corrected visual acuity (BCVA), swept-source optical coherence tomography (SS-OCT), and SS-OCT angiography. Subfoveal choroidal thickness, the width and height of serous retinal detachment (SRD), and the height and width of FIPED were measured. Pigment epithelial detachment type, subretinal hyperreflective deposits, dilated large choroidal vessels beneath FIPED, CNV, and the correspondence between FIPED and choriocapillaris flow voids were evaluated. Univariate comparisons and logistic regression were used to analyze factors associated with FIPED. Results Among 211 eyes, 94 (44.55%) had FIPED. The mean height and width of FIPED were (48.93±51.03) μm and (898.96±447.01) μm, respectively. FIPED corresponded to dilated large choroidal vessels in 93.62% (88/94) of eyes and to choriocapillaris flow voids in 88.30% (83/94). Compared with eyes without FIPED, eyes with FIPED were older, had worse BCVA, a higher proportion of cCSC, greater SRD width, and more frequent subretinal hyperreflective deposits (all P＜0.05). Among eyes with FIPED, the cCSC subgroup showed greater FIPED width and a higher CNV detection rate than the aCSC subgroup (P＜0.05). Logistic regression analysis showed that age [odds ratio (OR)=1.045, 95% confidence interval (CI) 1.003-1.090, P=0.037], cCSC (OR=5.052, 95%CI 2.550-10.009, P＜0.001), and subretinal hyperreflective deposits (OR=3.126, 95%CI 1.405-6.954, P=0.041) were independently associated with the presence of FIPED. Conclusions FIPED is an important imaging manifestation of CSC, particularly cCSC. Its presence is associated with older age, chronic disease course, and subretinal hyperreflective deposits, and with a higher likelihood of detectable CNV, especially in cCSC.

Citation： Xie Kunpeng, Liu Pei, An Guangqi, Li Shu, Lu Chenyu, Du Liping, Jin Xuemin. Risk factors for flat irregular pigment epithelial detachment in chronic central serous chorioretinopathy and its association with choroidal neovascularization. Chinese Journal of Ocular Fundus Diseases, 2026, 42(6): 495-499. doi: 10.3760/cma.j.cn511434-20250528-00236 Copy

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1. Van Rijssen TJ, van Dijk EHC, Yzer S, et al. Central serous chorioretinopathy: towards an evidence-based treatment guideline[J/OL]. Prog Retin Eye Res, 2019, 73: 100770[2019-07-15]. https://pubmed.ncbi.nlm.nih.gov/31319157/. DOI: 10.1016/j.preteyeres.2019.07.003.
2. Feenstra HMA, van Dijk EHC, Cheung CMG, et al. Central serous chorioretinopathy: an evidence-based treatment guideline[J/OL]. Prog Retin Eye Res, 2024, 101: 101236[2021-02-01]. https://pubmed.ncbi.nlm.nih.gov/38301969/. DOI: 10.1016/j.preteyeres.2024.101236.
3. Van Dijk E, Boon C. Serous business: delineating the broad spectrum of diseases with subretinal fluid in the macula[J/OL]. Prog Retin Eye Res, 2021, 84: 100955[2021-03-11]. https://pubmed.ncbi.nlm.nih.gov/33716160/. DOI: 10.1016/j.preteyeres.2021.100955.
4. Singh SR, Iovino C, Zur D, et al. Central serous chorioretinopathy imaging biomarkers[J]. Br J Ophthalmol, 2022, 106(4): 553-558. DOI: 10.1136/bjophthalmol-2020-317422.
5. Ciardella AP, Donsoff IM, Huang SJ, et al. Polypoidal choroidal vasculopathy[J]. Surv Ophthalmol, 2004, 49(1): 25-37. DOI: 10.1016/j.survophthal.2003.10.007.
6. Alex D, Giridhar A, Gopalakrishnan M, et al. Lateral elongation of flat irregular pigment epithelial detachment: a novel optical coherence tomography biomarker in polypoidal choroidal vasculopathy[J]. Indian J Ophthalmol, 2020, 68(1): 134-140. DOI: 10.4103/ijo.IJO_236_19.
7. Su Y, Zhang X, Gan Y, et al. Characteristics and associated factors of flat irregular pigment epithelial detachment with choroidal neovascularization in chronic central serous chorioretinopathy[J/OL]. Front Med (Lausanne), 2021, 8: 687023[2021-09-06]. https://pubmed.ncbi.nlm.nih.gov/34552940/. DOI: 10.3389/fmed.2021.687023.
8. Nair U, Ganekal S, Soman M, et al. Correlation of spectral domain optical coherence tomography findings in acute central serous chorioretinopathy with visual acuity[J]. Clin Ophthalmol, 2012, 6: 1949-1954. DOI: 10.2147/OPTH.S38363.
9. Shukla D, Aiello LP, Kolluru C, et al. Relation of optical coherence tomography and unusual angiographic leakage patterns in central serous chorioretinopathy[J]. Eye (Lond), 2008, 22(4): 592-596. DOI: 10.1038/sj.eye.6702818.
10. Parchand S, Gupta V, Gupta A, et al. Dark spot in fibrinous central serous chorioretinopathy masquerading choroiditis[J]. Ocul Immunol Inflamm, 2013, 21(3): 201-206. DOI: 10.3109/09273948.2013.765015.
11. Sahoo NK, Govindhari V, Bedi R, et al. Subretinal hyperreflective material in central serous chorioretinopathy[J]. Indian J Ophthalmol, 2020, 68(1): 126-129. DOI: 10.4103/ijo.IJO_265_19.
12. Rajesh B, Kaur A, Giridhar A, et al. "Vacuole" sign adjacent to retinal pigment epithelial defects on spectral domain optical coherence tomography in central serous chorioretinopathy associated with subretinal fibrin[J]. Retina, 2017, 37(2): 316-324. DOI: 10.1097/IAE.0000000000001192.
13. You EL, Hébert M, Jin TS, et al. Comparing interventions for chronic central serous chorioretinopathy: a network meta-analysis[J]. Surv Ophthalmol, 2023, 68(4): 601-614. DOI: 10.1016/j.survophthal.2023.03.001.
14. Iacono P, Da Pozzo S, Varano M, et al. Photodynamic therapy with verteporfin for chronic central serous chorioretinopathy: a review of data and efficacy[J/OL]. Pharmaceuticals (Basel), 2020, 13(11): 349[2020-10-29]. https://pubmed.ncbi.nlm.nih.gov/33137968/. DOI: 10.3390/ph13110349.
15. Liu T, Lin W, Zhou S, et al. Optical coherence tomography angiography of flat irregular pigment epithelial detachments in central serous chorioretinopathy[J]. Br J Ophthalmol, 2021, 105(2): 233-238. DOI: 10.1136/bjophthalmol-2019-315318.
16. Yu J, Jiang C, Xu G. Study of subretinal exudation and consequent changes in acute central serous chorioretinopathy by optical coherence tomography[J]. Am J Ophthalmol, 2014, 158(4): 752-756. DOI: 10.1016/j.ajo.2014.06.015.

Chinese Journal of Ocular Fundus Diseases

Risk factors for flat irregular pigment epithelial detachment in chronic central serous chorioretinopathy and its association with choroidal neovascularization

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