Anna C S Tan1, Daniel Simhaee2, Chandrakumar Balaratnasingam3, Kunal K Dansingani4, Lawrence A Yannuzzi5. 1. Vitreous Retina Macula Consultants of New York, New York, New York; LuEsther T. Mertz Retinal Research Center, Manhattan, Eye, Ear and Throat Hospital, New York, New York; Singapore National Eye Center/Singapore Eye Research Institute, Singapore, Singapore. Electronic address: annacstan@gmail.com. 2. LuEsther T. Mertz Retinal Research Center, Manhattan, Eye, Ear and Throat Hospital, New York, New York. 3. Vitreous Retina Macula Consultants of New York, New York, New York; LuEsther T. Mertz Retinal Research Center, Manhattan, Eye, Ear and Throat Hospital, New York, New York; Department of Physiology and Pharmacology, Centre for Ophthalmology and Visual Sciences, Lions Eye Institute, University of Western Australia, Perth, Australia. 4. Vitreous Retina Macula Consultants of New York, New York, New York; LuEsther T. Mertz Retinal Research Center, Manhattan, Eye, Ear and Throat Hospital, New York, New York; Truhlsen Eye Institute, University of Nebraska, Omaha, Nebraska. 5. Vitreous Retina Macula Consultants of New York, New York, New York; LuEsther T. Mertz Retinal Research Center, Manhattan, Eye, Ear and Throat Hospital, New York, New York.
Abstract
PURPOSE: To describe and compare the clinical and imaging characteristics of pigment epithelial detachments (PEDs) in age-related macular degeneration (AMD), polypoidal choroidal vasculopathy (PCV), and central serous chorioretinopathy (CSC) as seen in a clinical setting of a tertiary retinal practice. DESIGN: A perspective supported by clinical and imaging characteristics of a consecutive cohort of patients with strictly defined PEDs. RESULTS: One hundred seventy-four eyes of 113 patients with PEDs were studied with comprehensive clinical retinal examination and multimodal imaging; PEDs were differentiated into nonvascularized and vascularized forms with 3 main underlying etiologies: AMD (76%), PCV (9%), and CSC (3%). AMD was the most common diagnosis, with both nonvascularized PEDs (drusenoid and serous) and vascularized PEDs (type 1 and type 3 neovascularization) associated with drusen and a thin choroid. PCV patients had large, vascularized, peaked PEDs associated with polyps and a variable choroidal thickness, while CSC patients had a thick choroid and predominantly nonvascularized, serous PEDs with an overlying neurosensory detachment. The combined clinical and imaging characteristics form a profile for each PED subtype related to their underlying disease. However, atypical features noted in 11% of patients may complicate the underlying diagnosis. CONCLUSION: Typical phenotypic manifestations of PEDs and other features seen with multimodal imaging were associated with specific underlying etiologies. As suggested by our study, identification of these features help clinicians to determine the precise underlying etiology and manage both vascularized PEDs, where evidence-based treatment exists, and nonvascularized PEDs, where current treatment is not supported by convincing evidence.
PURPOSE: To describe and compare the clinical and imaging characteristics of pigment epithelial detachments (PEDs) in age-related macular degeneration (AMD), polypoidal choroidal vasculopathy (PCV), and central serous chorioretinopathy (CSC) as seen in a clinical setting of a tertiary retinal practice. DESIGN: A perspective supported by clinical and imaging characteristics of a consecutive cohort of patients with strictly defined PEDs. RESULTS: One hundred seventy-four eyes of 113 patients with PEDs were studied with comprehensive clinical retinal examination and multimodal imaging; PEDs were differentiated into nonvascularized and vascularized forms with 3 main underlying etiologies: AMD (76%), PCV (9%), and CSC (3%). AMD was the most common diagnosis, with both nonvascularized PEDs (drusenoid and serous) and vascularized PEDs (type 1 and type 3 neovascularization) associated with drusen and a thin choroid. PCV patients had large, vascularized, peaked PEDs associated with polyps and a variable choroidal thickness, while CSC patients had a thick choroid and predominantly nonvascularized, serous PEDs with an overlying neurosensory detachment. The combined clinical and imaging characteristics form a profile for each PED subtype related to their underlying disease. However, atypical features noted in 11% of patients may complicate the underlying diagnosis. CONCLUSION: Typical phenotypic manifestations of PEDs and other features seen with multimodal imaging were associated with specific underlying etiologies. As suggested by our study, identification of these features help clinicians to determine the precise underlying etiology and manage both vascularized PEDs, where evidence-based treatment exists, and nonvascularized PEDs, where current treatment is not supported by convincing evidence.
Authors: Kai Xiong Cheong; Dilraj Singh Grewal; Kelvin Yi Chong Teo; Alfred Tau Liang Gan; Glenn Jay Jaffe; Gemmy Chui Ming Cheung Journal: Eye (Lond) Date: 2020-02-11 Impact factor: 3.775
Authors: Marlene Saßmannshausen; Charlotte Behning; Ben Isselmann; Matthias Schmid; Robert P Finger; Frank G Holz; Steffen Schmitz-Valckenberg; Maximilian Pfau; Sarah Thiele Journal: Sci Rep Date: 2022-09-02 Impact factor: 4.996
Authors: A C S Tan; G S Tan; A K Denniston; P A Keane; M Ang; D Milea; U Chakravarthy; C M G Cheung Journal: Eye (Lond) Date: 2017-09-08 Impact factor: 3.775
Authors: Daren Hanumunthadu; Anna C S Tan; Sumit Randhir Singh; Niroj Kumar Sahu; Jay Chhablani Journal: Indian J Ophthalmol Date: 2018-12 Impact factor: 1.848