Document Detail

Type 1 (sub-retinal pigment epithelial) neovascularization in central serous chorioretinopathy masquerading as neovascular age-related macular degeneration.
MedLine Citation:
PMID:  22850219     Owner:  NLM     Status:  MEDLINE    
PURPOSE: The purpose of this study was to describe clinical and multimodal imaging features of patients with Type 1 neovascularization who lack findings of age-related macular degeneration but instead have features consistent with long-standing central serous chorioretinopathy (CSC).
METHODS: Nonconsecutive, retrospective, observational case series. Two groups of patients were identified and analyzed. Group 1 included patients presenting with Type 1 neovascularization who at the time of diagnosis were found to have findings more consistent with long-standing CSC than age-related macular degeneration. Group 2 included patients with a known history of CSC who developed Type 1 neovascularization over their course of follow-up. Clinical histories and multimodal imaging findings (color and red-free photography, fundus autofluorescence imaging, fluorescein angiography, indocyanine green angiography, spectral domain optical coherence tomography, and enhanced depth imaging optical coherence tomography) were analyzed.
RESULTS: Twenty-seven eyes of 22 patients were identified. Thirteen patients presented with Type 1 neovascularization thought to be secondary to CSC (Group 1), and 9 patients with CSC were observed to develop Type 1 neovascularization over their course of follow-up (Group 2). Eight patients (36%) had polypoidal neovascular structures within their Type 1 neovascular lesions, of which 4 (18% of all patients) had bilateral Type 1 neovascularization. The mean age of patients was 61 years (range, 48-76 years), and the median age was 58.5 years. Thirteen patients (59%) were men. For those patients in Group 2, the mean duration between diagnosis of CSC and detection of Type 1 neovascularization was 139 months (range, 7-365 months). The mean subfoveal choroidal thickness was 354 μm (range, 186-666 μm).
CONCLUSION: Some patients presenting with Type 1 neovascularization may have clinical and multimodal imaging findings more consistent with long-standing CSC than with age-related macular degeneration. These patients are more likely to be younger, men, have thicker choroids, and have a higher prevalence of polypoidal neovasculopathy than those patients with Type 1 neovascularization secondary to age-related macular degeneration. Proper identification of these patients may have implications for their natural course and management.
Adrian T Fung; Lawrence A Yannuzzi; K Bailey Freund
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Retina (Philadelphia, Pa.)     Volume:  32     ISSN:  1539-2864     ISO Abbreviation:  Retina (Philadelphia, Pa.)     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-25     Completed Date:  2013-01-18     Revised Date:  2013-03-17    
Medline Journal Info:
Nlm Unique ID:  8309919     Medline TA:  Retina     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1829-37     Citation Subset:  IM    
Department of Ophthalmology, New York University, New York, New York, USA.
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MeSH Terms
Central Serous Chorioretinopathy / complications,  diagnosis*
Coloring Agents / diagnostic use
Diagnosis, Differential
Fluorescein Angiography
Indocyanine Green / diagnostic use
Middle Aged
Retinal Neovascularization / complications,  diagnosis*
Retinal Pigment Epithelium / pathology*
Retrospective Studies
Tomography, Optical Coherence
Wet Macular Degeneration / diagnosis*
Reg. No./Substance:
0/Coloring Agents; 3599-32-4/Indocyanine Green

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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