Work

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

Year: 2026

Type: article

Abstract: 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: = 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.

Source: Ophthalmology Science

DOI: 10.1016/j.xops.2026.101404