How do serous PEDs appear on indocyanine green angiography (ICGA)?

Serous pigment epithelial detachments (PEDs) typically appear hypo-fluorescent on indocyanine green angiography (ICGA). This is due to the accumulation of fluid beneath the retinal pigment epithelium that leads to a decrease in fluorescence signal in the affected areas. The fluid between the retinal pigment epithelium and Bruch's membrane blocks the entry of the dye, resulting in lower intensity on the angiographic images.

In the context of ICGA, the hypo-fluorescence associated with serous PEDs can be an important clinical feature, helping clinicians differentiate these lesions from other types, such as fibrovascular PEDs, which may show different fluorescence patterns. Understanding this characteristic helps in diagnosing and managing conditions such as age-related macular degeneration (AMD) and other causes of choroidal neovascularization (CNV).