How does a pigment epithelial detachment appear on OCT?

A pigment epithelial detachment (PED) typically appears on optical coherence tomography (OCT) as a homogeneously colored area of hyper or isoreflectivity. This characteristic is due to the accumulation of fluid beneath the retinal pigment epithelium, which results in a dome-shaped elevation. The hyperreflectivity is often observed in cases where there is serous fluid accumulation, while an isoreflective aspect may be associated with more subtle detachments or chronic changes. This uniform appearance can help clinicians differentiate it from other pathologies, as various conditions tend to present with more varied reflectivity patterns.