On optical coherence tomography (OCT), how does serous PED appear?

Serous pigment epithelial detachment (PED) on optical coherence tomography (OCT) is characterized by its specific appearance. A serous PED presents as a dome-shaped elevation of the retinal pigment epithelium (RPE) that is filled with fluid. This fluid accumulation typically leads to a hypo-reflective appearance on OCT.

The hypo-reflectivity is due to the presence of subretinal fluid, which is less reflective compared to the surrounding retinal tissues. In contrast, if a PED were hyper-reflective, it would suggest the presence of solid material or fibrotic changes, which would not be characteristic of a serous detachment. Therefore, the dome-shaped and hypo-reflective nature of a serous PED on OCT accurately describes how it appears, making this the correct characterization.