title: Flat irregular retinal pigment epithelium detachments in chronic central serous chorioretinopathy and choroidal neovascularization.
abstract: OBJECTIVE
  To evaluate the incidence of flat, irregular pigment epithelium detachments (PEDs) in chronic central serous chorioretinopathy (CSC) and to determine whether they are consistent with active choroidal neovascularization (CNV).
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Review of medical records of patients with chronic CSC who were examined in the Ophthalmology Department of Lariboisière Hospital between June 1, 2007 and May 31, 2013. Multimodal imaging of the fundus, including optical coherence tomography (OCT), fundus autofluorescence, and indocyanine green and fluorescein angiography, was available in most cases.
  
  
  RESULTS
  One hundred and ten patients with chronic CSC were identified. Fifty-three eyes of 38 patients showed flat irregular PED on macular OCT examination. Mean age was 58.6 ± 13.2 years. Twenty-eight patients (73.6%) patients were male. Fifteen patients (39.4%) had bilateral flat irregular PEDs. The mean follow-up duration was 14.6 years (range: 2-39 years). PEDs were suggestive of type 1 CNV in 10 eyes, but no other signs of AMD, specifically no drusen, were present. In the remaining 43 eyes, flat irregular PEDs were stable over time (mean follow-up duration: 15 years) with no evidence of active neovascularization.
  
  
  CONCLUSIONS
  Although the possible occurrence of type 1 CNV complicating the course of chronic CSC should not be ignored, all cases of flat irregular PED should not be mistaken for active CNV and systematically treated with anti-VEGF. Nevertheless, in some cases with worsened vision not responding to usual CSC therapy, anti-VEGF could be considered as a therapeutic test to rule out the presence of secondary CNV.
authors.affiliation: Assistance Publique-Hôpitaux de Paris, AP-HP, Hôpital Lariboisière, Service d'Ophtalmologie, Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: Rabih
authors.initials: R
authors.lastname: Hage
authors.affiliation: Centre Hospitalier National des Quinze-Vingts, Service du Prof J. Sahel & Université Pierre et Marie Curie-Paris 6, Paris, France.
authors.forename: Sarah
authors.initials: S
authors.lastname: Mrejen
authors.affiliation: Assistance Publique-Hôpitaux de Paris, AP-HP, Hôpital Lariboisière, Service d'Ophtalmologie, Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Krivosic
authors.affiliation: Centre d'Imagerie et de Laser, Paris, France.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Quentel
authors.affiliation: Assistance Publique-Hôpitaux de Paris, AP-HP, Hôpital Lariboisière, Service d'Ophtalmologie, Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: Ramin
authors.initials: R
authors.lastname: Tadayoni
authors.affiliation: Assistance Publique-Hôpitaux de Paris, AP-HP, Hôpital Lariboisière, Service d'Ophtalmologie, Université Paris Diderot, Sorbonne Paris Cité, Paris, France; Centre d'Imagerie et de Laser, Paris, France. Electronic address: agaudric@gmail.com.
authors.forename: Alain
authors.initials: A
authors.lastname: Gaudric
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D056833:Central Serous Chorioretinopathy / Q000150:complications* / Q000175:diagnosis; D002829:Choroid / Q000098:blood supply; D020256:Choroidal Neovascularization / Q000150:complications* / Q000175:diagnosis; D002908:Chronic Disease; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D012163:Retinal Detachment / Q000150:complications* / Q000175:diagnosis; D055213:Retinal Pigment Epithelium / Q000473:pathology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green