Zhou Pengyi 1,2 , Liu Pei 1 , Zhu Haiyan 1,2 , Xie Kunpeng 1,2 , Jin Bo 1,2 , 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;
Jin Xuemin, Email: 2740913223@qq.com
Central serous chorioretinopathy; Choroidal neovascularization; Flat irregular pigment epithelial detachment; Choroidal thickness; Anti-vascular endothelial growth factor therapy
10.3760/cma.j.cn511434-20250728-00326
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Objective  To observe the morphological characteristics of flat irregular pigment epithelial detachment (FIPED) in eyes with chronic central serous chorioretinopathy (cCSC) and its association with choroidal neovascularization (CNV), and to evaluate the value of FIPED width as an early-warning imaging biomarker for CNV. Methods A retrospective clinical study. A total of 198 patients with cCSC involving 213 eyes who were diagnosed at the Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University from February 2021 to July 2025 were included. The disease duration from symptom onset to the first visit was ≥3 months. All affected eyes underwent best-corrected visual acuity (BCVA), swept-source optical coherence tomography (SS-OCT), SS-OCT angiography (SS-OCTA), and fundus fluorescein angiography (FFA). BCVA was measured using the international standard visual acuity chart and converted to the logarithm of the minimum angle of resolution (logMAR) for statistical analysis. Subfoveal choroidal thickness (SFCT), central macular thickness (CMT), and the width and height of FIPED were measured using SS-OCT. FIPED was identified on SS-OCTA B-scan images. CNV was identified on SS-OCTA images as abnormal vascular signals extending from the deep retinal layer to the choroidal layer. According to the presence or absence of CNV, the patients were divided into the CNV group (16 patients, 16 eyes) and the non-CNV group (182 patients, 197 eyes). Eyes with CNV received intravitreal anti-vascular endothelial growth factor (VEGF) therapy, with a mean of 3.13 injections. The follow-up duration after treatment was ＞12 months. Age, sex distribution, logMAR BCVA, and SFCT were compared between the two groups. Changes in logMAR BCVA, SFCT, and FIPED width and height before treatment and at the final follow-up were compared in CNV group. Intergroup comparisons were performed using the independent-samples t test. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic efficacy of FIPED width for CNV and to determine the cut-off value. Results Compared with non-CNV group, patients in CNV group were older (t=3.838), had a lower proportion of males, thinner SFCT (t=?2.635), worse BCVA (Z=?3.807), and greater FIPED width (t=3.515); all differences were statistically significant (P＜0.05). There was no significant difference in FIPED height between the two groups (Z=?0.698, P＞0.05). FIPED was present in 16 eyes in CNV group (100.00%, 16/16) and 80 eyes in non-CNV group (40.61%, 80/197), with a statistically significant difference (P＜0.001). ROC curve analysis showed that the area under the curve of FIPED width for diagnosing CNV was 0.796, and the optimal cut-off value was 914.15 μm. At the final follow-up in CNV group, BCVA was significantly improved, and FIPED width and height were significantly reduced compared with those before treatment; the differences were statistically significant (t=2.487, 6.354, 3.046; P＜0.05). There was no significant difference in SFCT (t=0.989, P＞0.05). Conclusions Increased FIPED width (＞914 μm) is significantly associated with CNV and may serve as a potential imaging early-warning marker for predicting secondary CNV in cCSC. However, its predictive value requires further validation in prospective studies. Anti-VEGF therapy can effectively reduce CNV-associated FIPED and improve visual acuity.

Citation： Zhou Pengyi, Liu Pei, Zhu Haiyan, Xie Kunpeng, Jin Bo, Du Liping, Jin Xuemin. Flat irregular pigment epithelial detachment width as a potential early warning marker for choroidal neovascularization secondary to chronic central serous chorioretinopathy. Chinese Journal of Ocular Fundus Diseases, 2026, 42(6): 500-506. doi: 10.3760/cma.j.cn511434-20250728-00326 Copy

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