How do Fibrovascular PEDs generally appear on OCT in contrast to serous PEDs?

Fibrovascular pigment epithelial detachments (PEDs) typically present as irregular elevations on optical coherence tomography (OCT) images due to the presence of sub-RPE neovascularization, which leads to a more complex structure involving both fluid and fibrous tissue. This irregularity results in a not optically empty interior, reflecting the underlying pathological changes associated with conditions like neovascular age-related macular degeneration (AMD). The presence of fibrovascular tissue within these detachments indicates active disease, distinguishing them from other types of PEDs that may have different fluid characteristics.

In contrast, serous PEDs tend to present with more uniform and smooth appearances and are often optically empty, suggesting that the space beneath the RPE is filled primarily with fluid without significant fibrous tissue involvement. Understanding the differences in OCT presentation helps in diagnosing and managing various retinal conditions effectively.