Ophthalmology science · 2026
Spatial Choroidal Analysis under Mid-Phase Hyperfluorescent Plaques Demonstrates Unique Signatures in Central Serous Chorioretinopathy: Macula Society International Central Serous Chorioretinopathy Research Network Report Number 20.
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Gregori Giulia, Sahoo Niroj Kumar, Hasan Nasiq, Vichare Atharva Ajay, Lall Shreyaa Rohindra, Chandra Vupparaboina Sharat, Gadari Adarsh, Gagliardi Oscar Matteo, Lupidi Marco, Mariotti Cesare, Saju Stanley, Cao Jessica, Wykoff Charles C, Vupparaboina Kiran Kumar, Chandra Bollepalli Sandeep, Wu Lihteh, Chhablani Jay, MICRoN Study Group
Аннотация
PURPOSE: To evaluate the spatial relationship between mid-phase hyperfluorescent plaques (MPHP) and choroidal vascularity in central serous chorioretinopathy (CSCR) using choroidal vascularity index (CVI) heat maps and enrichment ratio (ER) analysis.
DESIGN: Retrospective multicenter study.
SUBJECTS: Forty eyes from 40 patients with CSCR presenting MPHP on indocyanine green angiography (ICGA) at both baseline and follow-up were included.
METHODS: Choroidal vascularity index was calculated from spectral-domain OCT scans using an automated algorithm generating en face CVI heat maps. Mid-phase hyperfluorescent plaques areas were manually segmented after overlaying with ICGA images. Spatial association between MPHP and high-CVI regions was assessed using ER analysis at absolute CVI thresholds of 0.75 and 0.90. Eyes were further stratified according to MPHP area dynamics (increased vs. decreased) at follow-up.
MAIN OUTCOME MEASURES: Mean CVI inside versus outside the MPHP area; ER values at CVI thresholds of 0.75 and 0.90; intralesional CVI distribution; ER values by MPHP area dynamics subgroup.
RESULTS: Mean CVI was significantly higher within the MPHP area (0.72 ± 0.09) compared with the surrounding choroid (0.70 ± 0.09; paired Wilcoxon P < 0.01; mean difference, 0.022; 95% confidence interval, 0.010-0.033; Cohen d = 0.57). Enrichment ratio analysis demonstrated preferential localization of MPHP within high-CVI regions at the CVI threshold of 0.90 (ER > 0.90 = 1.67). Qualitative assessment revealed nonuniform intralesional CVI distribution in 70% of eyes. In subgroup analysis, eyes with increasing MPHP area showed a directional trend toward greater enrichment within regions of highest CVI values (ER > 0.90: median 1.43 vs. 0.84; t test P = 0.04, Mann‑Whitney P = 0.260), an exploratory finding.
CONCLUSIONS: Mid-phase hyperfluorescent plaques in CSCR are spatially associated with regions of increased choroidal vascularity, supporting a spatially driven model of disease. These hypothesis-generating findings highlight the potential value of CVI-based spatial mapping for improving disease characterization and, pending prospective validation, therapeutic targeting.
FINANCIAL DISCLOSURES: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
DESIGN: Retrospective multicenter study.
SUBJECTS: Forty eyes from 40 patients with CSCR presenting MPHP on indocyanine green angiography (ICGA) at both baseline and follow-up were included.
METHODS: Choroidal vascularity index was calculated from spectral-domain OCT scans using an automated algorithm generating en face CVI heat maps. Mid-phase hyperfluorescent plaques areas were manually segmented after overlaying with ICGA images. Spatial association between MPHP and high-CVI regions was assessed using ER analysis at absolute CVI thresholds of 0.75 and 0.90. Eyes were further stratified according to MPHP area dynamics (increased vs. decreased) at follow-up.
MAIN OUTCOME MEASURES: Mean CVI inside versus outside the MPHP area; ER values at CVI thresholds of 0.75 and 0.90; intralesional CVI distribution; ER values by MPHP area dynamics subgroup.
RESULTS: Mean CVI was significantly higher within the MPHP area (0.72 ± 0.09) compared with the surrounding choroid (0.70 ± 0.09; paired Wilcoxon P < 0.01; mean difference, 0.022; 95% confidence interval, 0.010-0.033; Cohen d = 0.57). Enrichment ratio analysis demonstrated preferential localization of MPHP within high-CVI regions at the CVI threshold of 0.90 (ER > 0.90 = 1.67). Qualitative assessment revealed nonuniform intralesional CVI distribution in 70% of eyes. In subgroup analysis, eyes with increasing MPHP area showed a directional trend toward greater enrichment within regions of highest CVI values (ER > 0.90: median 1.43 vs. 0.84; t test P = 0.04, Mann‑Whitney P = 0.260), an exploratory finding.
CONCLUSIONS: Mid-phase hyperfluorescent plaques in CSCR are spatially associated with regions of increased choroidal vascularity, supporting a spatially driven model of disease. These hypothesis-generating findings highlight the potential value of CVI-based spatial mapping for improving disease characterization and, pending prospective validation, therapeutic targeting.
FINANCIAL DISCLOSURES: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.