On FAF, how do Fibrovascular PEDs appear?

Fibrovascular pigment epithelial detachments (PEDs) on fundus autofluorescence (FAF) typically present as areas of both hyper and hypoautofluorescence. The hyperautofluorescent regions indicate the presence of lipofuscin accumulation or active cellular processes, while the hypoautofluorescent areas suggest reduced autofluorescence, often associated with the underlying alterations in the retinal pigment epithelium (RPE) and changes in underlying choriocapillaris perfusion. This mixed appearance is characteristic of fibrovascular PEDs, reflecting their complex composition, which includes both neovascularization and varying degrees of RPE integrity. This understanding is essential for diagnosing and differentiating conditions like age-related macular degeneration (AMD) and for evaluating the activity of choroidal neovascularization (CNV).