June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
Usual Multimodal Imaging Versus Spectralis “En-Face” OCT 2 Angiography: a new semiologic approach in healthy and AMD patients.
Author Affiliations & Notes
  • Gabriel J Coscas
    Department of Ophthalmology, Creteil Eye Clinic Univ Hospital, Creteil, France
    75006, Centre Ophtalmologique de l'Odeon, Paris, France
  • Florence Coscas
    Department of Ophthalmology, Creteil Eye Clinic Univ Hospital, Creteil, France
    75006, Centre Ophtalmologique de l'Odeon, Paris, France
  • Marco Lupidi
    75006, Centre Ophtalmologique de l'Odeon, Paris, France
    Eye Clinic, S. Maria Della Misericordia Hospital, Perugia, Italy
  • Valérie Krivosic
    Department of Ophthalmology, Creteil Eye Clinic Univ Hospital, Creteil, France
  • Catherine Favard
    75006, Centre Ophtalmologique de l'Odeon, Paris, France
  • Catherine Francais
    75006, Centre Ophtalmologique de l'Odeon, Paris, France
  • Eric H Souied
    Department of Ophthalmology, Creteil Eye Clinic Univ Hospital, Creteil, France
  • Footnotes
    Commercial Relationships Gabriel Coscas, Allergan (C), Bayer (C), Novartis (C); Florence Coscas, Allergan (C), Bayer (C), Novartis (C); Marco Lupidi, None; Valérie Krivosic, allergan (C), bayer (C), novartis (C); Catherine Favard, None; Catherine Francais, Bayer (C), Novartis (C), roche (C); Eric Souied, Allergan (C), Bayer (C), Novartis (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 5930. doi:
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      Gabriel J Coscas, Florence Coscas, Marco Lupidi, Valérie Krivosic, Catherine Favard, Catherine Francais, Eric H Souied; Usual Multimodal Imaging Versus Spectralis “En-Face” OCT 2 Angiography: a new semiologic approach in healthy and AMD patients.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5930.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To compare the results obtained with standard multimodal imaging versus En-Face OCT 2 ANGIOGRAPHY (OCT2-A) in Patients with exudative AMD and identify similarities or differences in 4 types of choroidal neovascularization.

 
Methods
 

Case series of 10 healthy and 80 eyes of 50 consecutive AMD patients (39 females, mean age 79.4 ± 5.3) diagnosed with different types of CNV (53 type I,12 predominantly classic, 6 Retinal Angiomatous Proliferation, 9 Polypoidal choroidal vasculopathy). Initial diagnosis was based on Fluorescein Angiography (FA), Indocyanine green angiography (ICGA), B-Scan OCT with two different examiners to the ones achieved with En-Face OCT2-A (Spectralis, Heidelberg Engineering) to help for the diagnosis and the decision of treatment. In conventional multimodal imaging, lesions were classified into subepithelial or preepithelial and mixed. The lesion's activity was evaluated according to leakage in FA and fluid accumulation in OCT. The new imaging with OCT2-A associated with En Face allowed to recognize the pattern of active CNV as hyperdense multiramified network due to active blood flow corresponding to hyperreflective network and fluid accumulation on "En Face". The system used by Spectralis is an Amplitude Decorrelation OCT device able to show in a B-scan OCT2-A the relationship between CNV and RPE layer.

 
Results
 

OCT2-A allows recognition of localization of CNV as sub or pre epithelial. The two methods achieved the same diagnosis about presence of subfoveal CNV (52/80).The diagnosis of active CNV based on FA leakage (25/52) was more easy than based on qualitative changes of morphology of CNV on OCT2-A (14/52) . The classification into 4 groups as usual, was applicable for both type I and II with OCT2-A using the unique possibility to have a B-scan section in OCT2-A. The diagnosis of active CNV was achieved with non invasive method (OCT2-A and En Face OCT) in all 52 cases.

 
Conclusions
 

Our study highlights the capability of the method of OCT2-A to determine the presence of subfoveal CNV, the diagnosis of activity, the classification into the well known four groups and particularly to distinguish sub and pre epithelial CNV. Nevertheless, even if FA remains the gold standard for the presence of leakage, the En-Face OCT could easily show fluid accumulation and its variations.  

 
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