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LETTER TO THE EDITOR
Year : 2020  |  Volume : 68  |  Issue : 4  |  Page : 671

Comment on: Flat irregular pigment epithelium detachment in central serous chorioretinopathy: Correlation with choroidal neovascular membrane


Department of Vitreo.Retina, ASG Eye Hospital, Jodhpur, Rajasthan, India

Date of Web Publication16-Mar-2020

Correspondence Address:
Dr. Preetkanwar Singh Sodhi
Department of Vitreo-Retina, ASG Eye Hospital, Jodhpur - 342 008, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1795_19

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How to cite this article:
Sodhi PS. Comment on: Flat irregular pigment epithelium detachment in central serous chorioretinopathy: Correlation with choroidal neovascular membrane. Indian J Ophthalmol 2020;68:671

How to cite this URL:
Sodhi PS. Comment on: Flat irregular pigment epithelium detachment in central serous chorioretinopathy: Correlation with choroidal neovascular membrane. Indian J Ophthalmol [serial online] 2020 [cited 2020 Apr 2];68:671. Available from: http://www.ijo.in/text.asp?2020/68/4/671/280713



Dear Sir,

Pachychoroid disease spectrum was first recognized by Warrow et al.[1] They are a group of conditions that present with increased choroidal thickness along with pachyvessels in the Haller's layer and thinning of the overlying choriocapillaris and Sattler's layer with/without associated degeneration of the retinal pigment epithelium (RPE).[2] It includes pachychoroid pigment epitheliopathy (PPE), central serous chorioretinopathy (CSCR), pachychoroid neovasculopathy (PNV), polypoidal choroidal vasculopathy (PCV), focal choroidal excavation (FCE), and peripapillary pachychoroid syndrome.

Gupta et al.[3] have presented a case of flat irregular pigment epithelial detachment (FIPED) in CSCR. The authors have correlated the reflectivity pattern noted on swept-source optical coherence tomography (SS-OCT) with fundus fluorescein angiography (FFA), indocyanine green angiography (ICG), and optical coherence tomography angiography (OCTA).

PNV resides within the spectrum of pachychoroid diseases and occurs due to the process of choroidal congestion and hyperpermeability. The characteristic features are the presence of type 1 neovascularization[2] in between the RPE and Bruch's membrane in the absence of soft drusens and reduced fundus tessellation due to choroidal thickening at a younger age. The presented case shows all the abovementioned features and should be labeled as PNV.

I would request the authors to comment on the subfoveal and localized choroidal thickness as the presented picture of OCT also shows a visibly thickened choroid below the FIPED.

Another important thing is the occurrence of aneurysms that originate from the type 1 lesions of PNV and has been described before.[4] This should be kept in mind while following up the presented case.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Warrow DJ, Hoang QV, Freund KB. Pachychoroid pigment epitheliopathy. Retina 2013;33:1659-72.  Back to cited text no. 1
    
2.
Cheung CMG, Lee WK, Koizumi H, Dansingani K, Lai TYY, Freund KB. Pachychoroid disease. Eye (Lond) 2019;33:14-33.   Back to cited text no. 2
    
3.
Gupta R, Chablani J. Flat irregular pigment epithelial detachment in central serous chorioretinopathy: Correlation with choroidal vascular membrane. Indian J Opthalmol 2019;67:1330-2.  Back to cited text no. 3
    
4.
Yannuzzi LA, Freund KB, Goldhaum M, Scassellati-Sforzolini B, Guyer DR, Spaide RF, et al. Polypoidal choroidal vasculopathy masquerading as central serous chorioretinopathy. Ophthalmology 2000;107:766-7.  Back to cited text no. 4
    




 

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