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MIDPHASE HYPERFLUORESCENT PLAQUES AS A BIOMARKER OF DISEASE ACTIVITY IN CENTRAL SEROUS CHORIORETINOPATHY: Clinical
Giulia Gregori1, Niroj Kumar Sahoo2, Nasiq Hasan2
1Department of Ophthalmology, Polytechnic University of Marche, Eye Clinic, Ancona, Italy.
Purpose:
To investigate the association between midphase hyperfluorescent plaques (MPHP) with subretinal fluid (SRF) dynamics in central serous chorioretinopathy (CSCR) and to assess response across different therapeutic modalities using a validated quantitative approach.
Methods:
This was a retrospective, multicenter study in patients with CSCR. All patients underwent baseline and follow-up indocyanine green angiography and enhanced depth imaging optical coherence tomography. MPHP were measured on midphase indocyanine green angiography images, and changes in MPHP number and area were correlated with various imaging parameters. Response of MPHP to different treatment modalities were also evaluated.
Results:
The study included 96 eyes of 60 patients, 50 men (83.33%) and 10 women (16.67%) with CSCR. Over a median follow-up of 31 months, significant reductions were observed in central macular thickness ( P = 0.003), SRF height ( P = 0.02), subfoveal choroidal thickness ( P = 0.001), and MPHP area ( P = 0.02), while MPHP number and best recorded visual acuity remained stable. Photodynamic therapy (PDT) and laser induced greater SRF reduction (-125.0 ± 143.2 µ m and -123.8 ± 139.5 µ m) and MPHP area decrease (-4.14 ± 6.13 mm 2 and -1.75 ± 2.98 mm 2 , respectively) compared with Eplerenone and observation ( P < 0.01). Multivariable analysis confirmed PDT as the strongest independent predictor of MPHP area regression ( P ≤ 0.001), while baseline SRF height and symptom duration predicted final SRF height ( P ≤ 0.02).
Conclusion:
MPHP represent a frequent and dynamic angiographic feature in CSCR, closely associated with disease activity. PDT significantly reduced MPHP area and promoted SRF resolution, supporting its role as an effective treatment.
Insights
Mid-phase hyperfluorescent plaques (MPHP) are linked to disease activity in central serous chorioretinopathy (CSCR). Photodynamic therapy (PDT) effectively reduced MPHP and subretinal fluid (SRF), indicating its therapeutic value.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Medical Imaging
Background:
- Central serous chorioretinopathy (CSCR) is a condition characterized by fluid accumulation under the retina.
- Mid-phase hyperfluorescent plaques (MPHP) are observed during indocyanine green angiography (ICG-A) in CSCR patients.
- The dynamic role of MPHP in CSCR and their response to treatment require further investigation.
Purpose of the Study:
- To investigate the association between mid-phase hyperfluorescent plaques (MPHP) and subretinal fluid (SRF) dynamics in central serous chorioretinopathy (CSCR).
- To quantitatively assess the response of MPHP to various therapeutic modalities in CSCR patients.
Main Methods:
- Retrospective, multicenter study involving 96 eyes of 60 CSCR patients.
- Utilized indocyanine green angiography (ICG-A) and enhanced depth imaging optical coherence tomography (EDI-OCT) for imaging.
- Quantified MPHP number and area, correlating changes with imaging parameters and treatment responses.
Main Results:
- Significant reductions in central macular thickness, SRF height, SFCT, and MPHP area were observed over a median follow-up of 31 months.
- Photodynamic therapy (PDT) and laser treatment showed greater SRF reduction and MPHP area decrease compared to eplerenone and observation.
- PDT was the strongest independent predictor of MPHP area regression; baseline SRF height and symptom duration predicted final SRF height.
Conclusions:
- MPHP are dynamic features in CSCR, closely associated with disease activity.
- PDT significantly reduces MPHP area and promotes SRF resolution, confirming its efficacy in treating CSCR.
- Quantitative assessment of MPHP dynamics aids in understanding CSCR progression and treatment response.
