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Dimple in vascularized serous pigment epithelial detachment secondary to neovascular age-related macular degeneration

  • Retinal Disorders
  • Published:
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Abstract

Background

To describe the “dimple,” a previously unreported structural optical coherence tomography (OCT) finding in vascularized serous pigment epithelial detachment (PED) secondary to neovascular age-related macular degeneration (AMD).

Methods

Retrospective, longitudinal, case series study. Clinical charts and multimodal imaging including OCT (structural and angiography) and dye-based angiography (fluorescein and indocyanine green) examinations of patients with dimple—defined as a localized invagination of the vascularized serous PED—were analyzed in 2 high-volume referral centers.

Results

Nineteen eyes of 18 patients were included. Mean follow-up was at 64.1 ± 35.8 months. The greater basal and height diameters of the vascularized serous PED were respectively 3425.8 ± 1049.6 μm and 667.1 ± 279.9 μm at baseline and 3076.2 ± 1649.9 μm (p = 0.8) and 368.3 ± 295.1 at last follow-up (p = 0.0006). OCT analysis identified 2 phenotypes of dimple: type 1 or (“top denting”) (9 eyes) and type 2 (or “side denting”) (10 eyes). Both phenotypes are associated with hyper-reflective holding sub-retinal pigment epithelium (RPE) band encompassing the posterior face of the RPE and extending to the Bruch’s membrane. Hyper-reflective holding band is not correlated with angiographic signs of neovascular tissue in all cases. During follow-up, no case of RPE tear was observed.

Conclusions

We describe the characteristics of the dimple and its association with hyper-reflective holding sub-RPE bands in the context of large vascularized serous PED in neovascular AMD. The presence of a dimple does not seem to be an additional risk factor for the development of RPE tearing in high-risk PED secondary to neovascular AMD.

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Authors and Affiliations

  1. Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil University Paris Est Créteil, 40 Avenue de Verdun, 94000, Créteil, France

    Vittorio Capuano, Alexandra Miere, Roberta Farci, Eric H. Souied & Giuseppe Querques

  2. Department of Ophthalmology, IRCCS Hospital San Raffaele, University Vita-Salute, Milan, Italy

    Riccardo Sacconi, Enrico Borrelli, Francesco Gelormini, Francesco Bandello & Giuseppe Querques

Authors
  1. Vittorio Capuano
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  2. Riccardo Sacconi
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  3. Enrico Borrelli
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  4. Alexandra Miere
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  5. Francesco Gelormini
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  6. Roberta Farci
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  7. Francesco Bandello
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  8. Eric H. Souied
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  9. Giuseppe Querques
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Corresponding author

Correspondence to Giuseppe Querques.

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Conflict of interest

Vittorio Capuano has received lecture fees from Bayer Schering-Pharma (Berlin, Germany) and Zeiss (Dublin, USA). He has also received travel grants from Novartis (Basel, Switzerland) and Bayer Schering-Pharma (Berlin, Germany). Riccardo Sacconi, Enrico Borrelli, Francesco Gelormini, and Roberta Farci: None. Alexandra Miere has received lecture fees from Optovue (Freemont, CA, USA) and Farmila-Thea (Clermont-Ferrand, France). She has also received travel grants from Novartis (Basel, Switzerland), Bayer Schering-Pharma (Berlin, Germany), and Allergan Inc. (Irvine, CA, USA). Francesco Bandello is a consultant for Alcon (Fort Worth, TX, USA), Alimera Sciences (Alpharetta, GA, USA), Allergan Inc. (Irvine, CA, USA), Farmila-Thea (Clermont-Ferrand, France), Bayer Schering-Pharma (Berlin, Germany), Bausch and Lomb (Rochester, NY, USA), Genentech (San Francisco, CA, USA), Hoffmann-La-Roche (Basel, Switzerland), Novagali Pharma (Évry, France), Novartis (Basel, Switzerland), Sanofi-Aventis (Paris, France), Thrombogenics (Heverlee, Belgium), and Zeiss (Dublin, USA). Eric H Souied is a consultant for Alcon (Fort Worth, TX, USA), Alimera Sciences (Alpharetta, GA, USA), Allergan Inc. (Irvine, CA, USA), Farmila-Thea (Clermont-Ferrand, France), Bayer Schering-Pharma (Berlin, Germany), Bausch and Lomb (Rochester, NY, USA), Genentech (San Francisco, CA, USA), Heidelberg (Germany), and Novartis (Basel, Switzerland). Giuseppe Querques is a consultant for Alimera Sciences (Alpharetta, GA, USA), Allergan Inc. (Irvine, CA, USA), Bayer Schering-Pharma (Berlin, Germany), Heidelberg (Germany), Novartis (Basel, Switzerland), Sandoz (Berlin, Germany), and Zeiss (Dublin, USA).

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Capuano, V., Sacconi, R., Borrelli, E. et al. Dimple in vascularized serous pigment epithelial detachment secondary to neovascular age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 258, 1597–1605 (2020). https://doi.org/10.1007/s00417-020-04732-6

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  • DOI: https://doi.org/10.1007/s00417-020-04732-6

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