Retina 2025 Dec 15; doi: 10.1097/IAE.0000000000004754.

Imaging characteristics of macular neovascularization in chronic central serous chorioretinopathy patients.

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PURPOSE: To study the morphological characteristics of type1 macular neovascularization (MNV) in eyes with chronic central serous chorioretinopathy (CSCR) using optical coherence tomography (OCT) and OCT angiography (OCTA). METHODS: Patients with chronic CSCR and secondary type 1 MNV were included in the study. Macular OCT and OCTA images were acquired, and morphological characteristics along with quantifiable features were analyzed. RESULTS: Twenty eyes of 19 patients were included. All eyes exhibited neovascular flow signal on OCTA images. Nineteen (95%) of eyes showed flat-irregular pigment epithelium detachment (FIPED). Subretinal fluid was detected in 90% of patients with no intra-retinal fluid. Membranes were mostly located at the subfoveal area (65%). All membranes were identified in the location overlying choroidal pachyvessels. Mature membranes with a loose vascular configuration were identified in 75% of eyes. Morphological biomarkers of "indistinct" (65%), "tangled" (30%) and "sea-fan" (5%) patterns were recorded. Feeder vessels was identified in 75% of membranes. Average vascular density was measured as 46% (± 10%). CONCLUSION: Neovascular membrane of chronic CSCR sprout under the retinal pigment epithelium within the macular area (type 1 MNV) inside a FIPED overlying pachyvessels. Morphologic characteristics assessed by OCTA of loose and indistinct pattern improve our understanding of vessel formation and maturation in chronic CSCR patients and might be valuable to guide therapy.

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