Punctate Hyperfluorescent Spots on Indocyanine Green Angiography in Eyes with Central Serous Chorioretinopathy and...

Purpose: To investigate the clinical significance of punctate hyperfluorescent spots (PHS) on indocyanine green angiography (ICGA) in patients with central serous chorioretinopathy (CSCR). Methods: In this retrospective study, 87 eyes of 87 patients diagnosed with CSCR through comprehensive multimodal imaging were analyzed. Eyes with a cluster of five or more PHS on ICGA were classified as PHS (+), and eyes with four or fewer as PHS (-). Clinical parameters, including age, blood pressure, visual acuity, and imaging features such as choroidal venous dilation, choroidal vascular hyperpermeability (CVH), pachydrusen, and the status of PHS in the CSCR-unaffected fellow eyes, were compared between the two groups. Logistic regression analysis was performed to identify independent factors associated with PHS (+) status. Results: The PHS (+) group consisted of 63 (72.4%) eyes and the PHS (-) group 24 (27.6%) eyes. In the PHS (+) group, patients were significantly older (p = 0.031) and had higher systolic blood pressure (p = 0.030) and worse best-corrected visual acuity (p = 0.040) than those in the PHS (-) group. Notably, the PHS (+) group showed a significantly higher prevalence of PHS clusters in the fellow eye than the PHS (-) group (81.7% vs. 34.8%, p < 0.001). In univariate analysis, age (p = 0.045), venous dilation (p = 0.041), CVH (p = 0.034), and PHS clusters in the fellow eye (p < 0.001) were significantly associated with PHS clusters in the study eye. In multivariate analysis adjusted for multiple confounders, venous dilation (p = 0.026) and the presence of cluster PHS in the fellow eye (p = 0.001) remained significantly associated, and CVH tended to be significant (p = 0.089). Conclusions: PHS clusters are a frequent finding in eyes with CSCR, associated with venous dilation, CVH, and PHS in the CSCR-unaffected fellow eye. These conditions may predispose eyes to pachychoroid diseases such as CSCR.