LONG-TERM NATURAL COURSE OF AVASCULAR SEROUS PIGMENT EPITHELIAL DETACHMENT IN AGE-RELATED MACULAR DEGENERATION.

PURPOSE: To investigate the long-term natural history of avascular serous pigment epithelial detachment (PED) in age-related macular degeneration and identify risk factors for choroidal neovascularization (CNV) development.

METHODS

This retrospective study analyzed 71 eyes from 50 patients with pure avascular serous PED because of age-related macular degeneration, diagnosed via fluorescein angiography and indocyanine-green angiography. Patients were followed for at least 12 months (mean follow-up: 54.9 months). Baseline and follow-up assessments included best-corrected visual acuity and optical coherence tomography measurements of PED height and diameter. Disease progression was categorized as stable, atrophic, or CNV development, and statistical analyses identified CNV risk factors.

RESULTS

Among studied eyes, 15.5% developed CNV, 21.1% progressed to atrophy, and 63.4% remained stable. Larger baseline PED height and diameter significantly correlated with CNV risk ( P = 0.004 and P = 0.003, respectively). Every 100 µ m increase in PED height and diameter raised CNV risk by 50% and 10%, respectively. Best-corrected visual acuity declined in all groups, with greater deterioration in CNV and atrophic cases.

CONCLUSION

Larger PED height and diameter are significant CNV risk factors in avascular serous PED. OCT-based monitoring is crucial for early detection of high-risk cases, optimizing clinical management, and preventing vision loss in age-related macular degeneration patients.