Comprehensive analysis of pachyvessel morphology in central serous chorioretinopathy using multimodal imaging

Abstract The purpose of this study was to identify characteristic morphological features of large choroidal blood vessels (pachyvessels) in eyes with central serous chorioretinopathy (CSC) using enhanced depth imaging (EDI) optical coherence tomography (OCT). A total of 116 eyes from 58 patients wit...

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Main Authors: Mingui Kong, So Young Han, Yun-Mi Song, Sung Yong Park, Don-Il Ham
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-12718-9
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author Mingui Kong
So Young Han
Yun-Mi Song
Sung Yong Park
Don-Il Ham
author_facet Mingui Kong
So Young Han
Yun-Mi Song
Sung Yong Park
Don-Il Ham
author_sort Mingui Kong
collection DOAJ
description Abstract The purpose of this study was to identify characteristic morphological features of large choroidal blood vessels (pachyvessels) in eyes with central serous chorioretinopathy (CSC) using enhanced depth imaging (EDI) optical coherence tomography (OCT). A total of 116 eyes from 58 patients with CSC and 116 eyes from 58 age- and gender-matched healthy subjects were included. EDI OCT raster scan images were analyzed for the presence of characteristic features of pachyvessels and accompanying retinal pigment epithelial (RPE) abnormalities, with additional imaging data obtained from fluorescein angiography (FA) and indocyanine green angiography (ICGA). Severely dilated pachyvessels abutting the RPE-Bruch’s membrane-choriocapillaris complex, referred to as the “Hanging Drop (HD) sign,” were identified in all acute CSC eyes and 86.4% of CSC eyes overall. The HD sign was observed either with (“active”) or without (“inactive”) vascular wall hyperreflectivity along the RPE-Bruch’s membrane-choriocapillaris complex. The active HD sign was present exclusively in CSC eyes (56.1%) and was significantly more frequent in acute CSC compared to chronic and resolved CSC (88.9%, 47.4%, and 17.6%, respectively; P < 0.05). While the inactive HD sign was also more common in CSC eyes than in unaffected fellow eyes and healthy eyes (77.3%, 30.0%, and 9.5%, respectively), its prevalence did not differ significantly among CSC eyes with varying clinical conditions (P > 0.05). RPE abnormalities were consistently observed in OCT images showing the active HD sign. These findings suggest that characteristic morphological features of pachyvessels discerned using EDI OCT raster scans can aid in the diagnosis and evaluation of CSC.
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spelling doaj-art-1e425ef2b1e74fcdbb1cd4ee928d72592025-08-20T04:02:46ZengNature PortfolioScientific Reports2045-23222025-07-0115111610.1038/s41598-025-12718-9Comprehensive analysis of pachyvessel morphology in central serous chorioretinopathy using multimodal imagingMingui Kong0So Young Han1Yun-Mi Song2Sung Yong Park3Don-Il Ham4Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of MedicineDepartment of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of MedicineDepartment of Family Medicine, Center for Clinical Research, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of MedicineYesung Jung Eye ClinicDepartment of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of MedicineAbstract The purpose of this study was to identify characteristic morphological features of large choroidal blood vessels (pachyvessels) in eyes with central serous chorioretinopathy (CSC) using enhanced depth imaging (EDI) optical coherence tomography (OCT). A total of 116 eyes from 58 patients with CSC and 116 eyes from 58 age- and gender-matched healthy subjects were included. EDI OCT raster scan images were analyzed for the presence of characteristic features of pachyvessels and accompanying retinal pigment epithelial (RPE) abnormalities, with additional imaging data obtained from fluorescein angiography (FA) and indocyanine green angiography (ICGA). Severely dilated pachyvessels abutting the RPE-Bruch’s membrane-choriocapillaris complex, referred to as the “Hanging Drop (HD) sign,” were identified in all acute CSC eyes and 86.4% of CSC eyes overall. The HD sign was observed either with (“active”) or without (“inactive”) vascular wall hyperreflectivity along the RPE-Bruch’s membrane-choriocapillaris complex. The active HD sign was present exclusively in CSC eyes (56.1%) and was significantly more frequent in acute CSC compared to chronic and resolved CSC (88.9%, 47.4%, and 17.6%, respectively; P < 0.05). While the inactive HD sign was also more common in CSC eyes than in unaffected fellow eyes and healthy eyes (77.3%, 30.0%, and 9.5%, respectively), its prevalence did not differ significantly among CSC eyes with varying clinical conditions (P > 0.05). RPE abnormalities were consistently observed in OCT images showing the active HD sign. These findings suggest that characteristic morphological features of pachyvessels discerned using EDI OCT raster scans can aid in the diagnosis and evaluation of CSC.https://doi.org/10.1038/s41598-025-12718-9CSCPachychoroidPachyvesselsRPEBruch’s membrane
spellingShingle Mingui Kong
So Young Han
Yun-Mi Song
Sung Yong Park
Don-Il Ham
Comprehensive analysis of pachyvessel morphology in central serous chorioretinopathy using multimodal imaging
Scientific Reports
CSC
Pachychoroid
Pachyvessels
RPE
Bruch’s membrane
title Comprehensive analysis of pachyvessel morphology in central serous chorioretinopathy using multimodal imaging
title_full Comprehensive analysis of pachyvessel morphology in central serous chorioretinopathy using multimodal imaging
title_fullStr Comprehensive analysis of pachyvessel morphology in central serous chorioretinopathy using multimodal imaging
title_full_unstemmed Comprehensive analysis of pachyvessel morphology in central serous chorioretinopathy using multimodal imaging
title_short Comprehensive analysis of pachyvessel morphology in central serous chorioretinopathy using multimodal imaging
title_sort comprehensive analysis of pachyvessel morphology in central serous chorioretinopathy using multimodal imaging
topic CSC
Pachychoroid
Pachyvessels
RPE
Bruch’s membrane
url https://doi.org/10.1038/s41598-025-12718-9
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