CHOROIDAL FINDINGS IN THE COURSE OF IDIOPATHIC SEROUS PIGMENT-EPITHELIUM DETACHMENT DETECTED BY INDOCYANINE GREEN VIDEOANGIOGRAPHY

Purpose: To analyze the choroidal alterations associated with idiopath ic serous pigment epithelium detachment. Methods: Twenty-five consecut ive patients affected by idiopathic serous pigment epithelium detachme nt underwent ophthalmoscopy, fluorescein angiography, and indocyanine green videoangiography. Results: On indocyanine green videoangiography an early, complete, and homogeneous filling of the pigment epithelium detachment was always observed. In the late phases, the indocyanine g reen pattern depended on the size of the detachment. An idiopathic ser ous pigment epithelium detachment larger than the diameter of one opti c disk was still hyperfluorescent in the late phases of indocyanine gr een videoangiography and was surrounded by a ring of brighter hyperflu orescence. An idiopathic serous pigment epithelium detachment smaller than the diameter of one optic disk usually could be visualized in the late phases as a hypofluorescent area surrounded by a hyperfluorescen t ring. In 30 eyes (83.3%), choroidal hyperpermeability was observed, An irregular dilatation of the choroidal veins at the site or within a n area the size of one disk diameter from the detachments could be vis ualized on indocyanine green videoangiography in 12 of 36 affected eye s (33.3%); in three cases an active focus of central serous chorioreti nopathy with subretinal leakage developed in the follow-up period,Conc lusion: The observation that pigment epithelium detachments frequently are associated with choroidal leakage and venous dilatation supports the hypothesis that an idiopathic serous pigment epithelium detachment is a variant of central serous chorioretinopathy. Moreover, the choro idal permeability alterations detected by indocyanine green videoangio graphy would support the theory of Gass that idiopathic serous pigment epithelium detachments could be caused by exudation of fluids from th e choroidal vessels.