ArticleOphthalmology science2026
Association of Retinal Pigment Epithelium Pump Function Reversal with Choroidal Vascularity Index in Treatment-Naïve Central Serous Chorioretinopathy.
Article in Ophthalmology science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
Objective: To investigate the relationship between reversal of retinal pigment epithelium (RPE) pump function and choroidal architecture in treatment-naïve central serous chorioretinopathy (CSC), using choroidal vascularity index (CVI) as a quantitative biomarker. Design: Post hoc analysis of a prospective single-center cohort study. Subjects: Ninety eyes from 74 patients with treatment-naïve CSC were initially evaluated. Five eyes were excluded because of insufficient image quality, leaving 85 eyes from 70 patients for the final analysis. Methods: Eyes with treatment-naïve CSC underwent multimodal imaging. Swept-source OCT images were analyzed to assess choroidal architecture, including luminal area (LA), stromal area (SA), total choroidal area (TCA), and choroidal vascularity index (CVI), using a validated binarization technique. Reversal of RPE pump function was defined by either the presence of an intense inkblot leak on fluorescein angiography (FA) or a hyporeflective subretinal lucency sign on OCT. Associations between choroidal parameters and RPE pump reversal were evaluated using linear mixed-effects models to account for inter-eye correlation. Main Outcome Measures: Differences in CVI, TCA, LA, and SA in eyes with and without evidence of RPE pump reversal. Results: Retinal pigment epithelium pump reversal was observed in 58 eyes (68.20%). All exhibited an FA-based intense inkblot leak, and 8 eyes (13.79%) demonstrated the OCT-based hyporeflective subretinal lucency sign. Eyes with pump reversal showed significantly higher CVI ( Conclusions: Retinal pigment epithelium pump reversal is associated with increased CVI, suggesting a relationship between increased vascular proportion within the choroid and RPE dysfunction. In this context, CVI may serve as a useful marker of functional disease activity. These findings support the concept of CSC as a pachychoroid-driven disorder and provide further insight into its complex and multifactorial pathophysiology. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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