PMID- 33833415 OWN - NLM STAT- MEDLINE DCOM- 20220414 LR - 20230402 IS - 1476-5454 (Electronic) IS - 0950-222X (Print) IS - 0950-222X (Linking) VI - 36 IP - 4 DP - 2022 Apr TI - Small dome-shaped pigment epithelium detachment in polypoidal choroidal vasculopathy: an under-recognized sign of polypoidal lesions on optical coherence tomography? PG - 733-741 LID - 10.1038/s41433-020-01390-0 [doi] AB - PURPOSE: To evaluate the diagnostic accuracy of spectral-domain optical coherence tomography (SD-OCT) and swept-source optical coherence tomographic angiography (SS-OCTA) to identify polypoidal lesions in serous or serosanguinous maculopathy. MATERIALS AND METHODS: A retrospective review of patients presenting pigment epithelial detachments (PEDs) with the diagnosis of polypoidal choroidal vasculopathy (PCV), neovascular age-related macular degeneration (nAMD), and central serous chorioretinopathy (CSC), all of which underwent SD-OCT, SS-OCTA, and indocyanine green angiography (ICGA). Typical features of polypoidal lesions on SD-OCT included sharply peaked PED, notched PED, and hyperreflective ring underneath PED. SS-OCTA feature was vascularized PEDs on cross-sectional images corresponding to cluster-like structures on en face images. The parameters of PEDs were measured for analysis. RESULTS: Of 72 eyes, 30 had PCV, 22 had nAMD, and 20 had CSC. A total of 128 localized PEDs were detected on SD-OCT. Typical features on SD-OCT had a high specificity (94.0%) but a limited sensitivity (73.8%). SS-OCTA features provided a higher sensitivity (96.7%). PEDs of the polypoidal lesions unrecognized by SD-OCT were dome-shaped, with smaller ratio of height to base diameter and less area, and almost had heterogeneous internal reflectivity and a connected double-layer sign. Some lesions misidentified by SS-OCTA developed into ICGA-proven polypoidal lesions at follow-up visits. CONCLUSION: A small dome-shaped PED with heterogeneous internal reflectivity and a connected double-layer sign on SD-OCT may suggest a polypoidal lesion of PCV. SS-OCTA may be a helpful tool to investigate preclinical PCV and observe the formation of polypoidal lesions. CI - (c) 2021. The Author(s), under exclusive licence to The Royal College of Ophthalmologists. FAU - Wang, Yuwei AU - Wang Y AD - Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. AD - National Clinical Research Center for Eye Diseases, Shanghai, China. FAU - Bo, Qiyu AU - Bo Q AD - Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. AD - National Clinical Research Center for Eye Diseases, Shanghai, China. FAU - Jia, Huixun AU - Jia H AD - Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. AD - National Clinical Research Center for Eye Diseases, Shanghai, China. FAU - Sun, Mengsha AU - Sun M AD - Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. AD - National Clinical Research Center for Eye Diseases, Shanghai, China. FAU - Yu, Yang AU - Yu Y AD - Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. FAU - Huang, Peirong AU - Huang P AD - Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. AD - National Clinical Research Center for Eye Diseases, Shanghai, China. FAU - Wang, Jing AU - Wang J AD - Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. AD - National Clinical Research Center for Eye Diseases, Shanghai, China. FAU - Xu, Nana AU - Xu N AD - Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. AD - National Clinical Research Center for Eye Diseases, Shanghai, China. FAU - Wang, Fenghua AU - Wang F AUID- ORCID: 0000-0001-9670-1036 AD - Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. shretina@sjtu.edu.cn. AD - National Clinical Research Center for Eye Diseases, Shanghai, China. shretina@sjtu.edu.cn. AD - Shanghai Key Laboratory of Fundus Diseases, Shanghai, China. shretina@sjtu.edu.cn. FAU - Wang, Hong AU - Wang H AD - Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. wanghong700520@126.com. AD - National Clinical Research Center for Eye Diseases, Shanghai, China. wanghong700520@126.com. AD - Shanghai Key Laboratory of Fundus Diseases, Shanghai, China. wanghong700520@126.com. FAU - Sun, Xiaodong AU - Sun X AD - Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. AD - National Clinical Research Center for Eye Diseases, Shanghai, China. AD - Shanghai Key Laboratory of Fundus Diseases, Shanghai, China. LA - eng PT - Journal Article DEP - 20210408 PL - England TA - Eye (Lond) JT - Eye (London, England) JID - 8703986 RN - 0 (Coloring Agents) RN - IX6J1063HV (Indocyanine Green) SB - IM MH - Choroid/pathology MH - *Choroidal Neovascularization/diagnosis/pathology MH - Coloring Agents MH - Epithelium/pathology MH - Fluorescein Angiography/methods MH - Humans MH - Indocyanine Green MH - *Polyps/diagnosis MH - *Retinal Detachment/diagnostic imaging/pathology MH - Retrospective Studies MH - Tomography, Optical Coherence/methods PMC - PMC8956584 COIS- The authors declare that they have no conflict of interest. EDAT- 2021/04/10 06:00 MHDA- 2022/04/15 06:00 PMCR- 2023/04/01 CRDT- 2021/04/09 06:19 PHST- 2020/04/02 00:00 [received] PHST- 2020/12/18 00:00 [accepted] PHST- 2020/11/27 00:00 [revised] PHST- 2021/04/10 06:00 [pubmed] PHST- 2022/04/15 06:00 [medline] PHST- 2021/04/09 06:19 [entrez] PHST- 2023/04/01 00:00 [pmc-release] AID - 10.1038/s41433-020-01390-0 [pii] AID - 1390 [pii] AID - 10.1038/s41433-020-01390-0 [doi] PST - ppublish SO - Eye (Lond). 2022 Apr;36(4):733-741. doi: 10.1038/s41433-020-01390-0. Epub 2021 Apr 8.