September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Comparison of SD-OCT and OCT-Angiography Features in Presumed Choroidal Neovascularization in the AVATAR study
Author Affiliations & Notes
  • Deepa Manjunath
    Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Sunil K Srivastava
    Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Rishi P Singh
    Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Peter K Kaiser
    Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Aleksandra Rachitskaya
    Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Justis P Ehlers
    Cleveland Clinic Foundation, Cleveland, Ohio, United States
  • Footnotes
    Commercial Relationships   Deepa Manjunath, None; Sunil Srivastava, Allergan (F), Bausch and Lomb (C), Bausch and Lomb (F), Bioptigen (P), Carl Zeiss Meditec (C), Leica (C), Santen (C), Synergetics (P); Rishi Singh, Carl Zeiss Meditec (C); Peter Kaiser, Alcon (C), Bausch and Lomb (C), Bayer (C), Carl Zeiss Meditec (C), Genentech (C), Novartis (C), Ohr (C), Ophthotech (C), Oraya (C), Regeneron (C), Topcon (C); Aleksandra Rachitskaya, None; Justis Ehlers, Alcon (C), Bioptigen/Leica (C), Bioptigen/Leica (P), Bioptigen/Leica (F), Genentech (F), Regeneron (F), Santen (C), Synergetics (P), Thrombogenics (F), Thrombogenics (C), Zeiss (C), Zeiss (F)
  • Footnotes
    Support  NIH/NEI K23-EY022947-01A1; Ohio Department of Development TECH-13-059
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 1628. doi:
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      Deepa Manjunath, Sunil K Srivastava, Rishi P Singh, Peter K Kaiser, Aleksandra Rachitskaya, Justis P Ehlers; Comparison of SD-OCT and OCT-Angiography Features in Presumed Choroidal Neovascularization in the AVATAR study. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1628.

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

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Abstract

Purpose : Spectral domain optical coherence tomography (SD-OCT) is the current standard imaging modality for monitoring exudative activity secondary to choroidal neovascular tissue (CNV) in patients with macular disease. Optical coherence tomography angiography (OCT-A) is an emerging modality that allows direct visualization of flow within CNV vessels. It is not known how the detection of CNV by OCT-A compares with detection of choroidal neovascular exudation by SD-OCT. The purpose of this study was to evaluate the comparative features of the two modalities in eyes with presumed CNV.

Methods : This was an IRB-approved prospective observational study examining OCT-A in eyes undergoing SD-OCT for macular disease, the AVATAR study. All patients were imaged with the Avanti RTVue XR HD (Optovue, Fremont, CA) and the Cirrus HD-OCT system (Zeiss, Oberkochen, Germany). The Avanti system was equipped with prototype SSADA algorithm software to generate segmented retinal OCT-A scans. Images were reviewed by a masked expert reviewer. SD-OCT scans were assessed for intraretinal fluid, subretinal fluid, subretinal hyperreflective material, and subretinal pigment epithelial material. OCT-A scans were assessed for the presence or absence of CNV, defined as flow signal in the outer retina and/or abnormal vascular flow in the choroid.

Results : A total of 81 eyes were imaged. Thirty-five eyes had subretinal and/or intraretinal fluid on SD-OCT while 46 were negative for fluid. Of the eyes with positive fluid on SD-OCT, 69% (24/35) had CNV on OCT-A, 14% (5/35) did not have CNV on OCT-A, and 17% (6/35) were indeterminate. Of the eyes with negative fluid on SD-OCT, 30% (14/46) had CNV on OCT-A, 50% (23/46) did not have CNV on OCT-A, and 20% (9/46) were indeterminate.

Conclusions : OCT-A provides a unique opportunity for visualization of CNV in eyes with macular disease. OCT-A may predict active flow within CNV in the absence of exudative signs on SD-OCT. Further research is needed to better delineate the specific roles for OCT-A in the management of CNV.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

SD-OCT and OCT-angiography of eyes with presumed choroidal neovascularization (CNV). 3x3-mm OCT-A scans were segmented at the choriocapillaris. (a) Subretinal fluid on SD-OCT (arrows) corresponds to CNV on OCT-A. (b) Intraretinal fluid is positive on SD-OCT (arrows) but there is no CNV on OCT-A. (c) CNV can be seen on OCT-A but SD-OCT fluid is negative.

SD-OCT and OCT-angiography of eyes with presumed choroidal neovascularization (CNV). 3x3-mm OCT-A scans were segmented at the choriocapillaris. (a) Subretinal fluid on SD-OCT (arrows) corresponds to CNV on OCT-A. (b) Intraretinal fluid is positive on SD-OCT (arrows) but there is no CNV on OCT-A. (c) CNV can be seen on OCT-A but SD-OCT fluid is negative.

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