June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Analysis of Polypoidal Choroidal Vasculopathy Using Swept Source Optical Coherence Tomography Angiography with Variable Interscan Time Analysis
Author Affiliations & Notes
  • Carlos Augusto Moreira Neto
    Ophthalmology, Tufts University, Boston, Massachusetts, United States
    Ophthalmology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
  • Carl B Rebhun
    Ophthalmology, Tufts University, Boston, Massachusetts, United States
  • Stefan B. Ploner
    Department of Electrical Engineering and Computer Science, and Research Laboratory of Electronics,, Massachusetts Institute of Technology, Boston, Massachusetts, United States
  • Eric M. Moult
    Department of Electrical Engineering and Computer Science, and Research Laboratory of Electronics,, Massachusetts Institute of Technology, Boston, Massachusetts, United States
    Ophthalmology, Tufts University, Boston, Massachusetts, United States
  • Eduardo Amorim Novais
    Ophthalmology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
  • A. Yasin Alibhai
    Ophthalmology, Tufts University, Boston, Massachusetts, United States
  • Julia Schottenhamml
    Department of Electrical Engineering and Computer Science, and Research Laboratory of Electronics,, Massachusetts Institute of Technology, Boston, Massachusetts, United States
  • Ricardo Louzada
    Ophthalmology, Tufts University, Boston, Massachusetts, United States
  • Nadia Waheed
    Ophthalmology, Tufts University, Boston, Massachusetts, United States
  • Andre J Witkin
    Ophthalmology, Tufts University, Boston, Massachusetts, United States
  • Caroline R Baumal
    Ophthalmology, Tufts University, Boston, Massachusetts, United States
  • Jay S Duker
    Ophthalmology, Tufts University, Boston, Massachusetts, United States
  • James G Fujimoto
    Department of Electrical Engineering and Computer Science, and Research Laboratory of Electronics,, Massachusetts Institute of Technology, Boston, Massachusetts, United States
  • Daniela Ferrara
    Ophthalmology, Tufts University, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Carlos Moreira Neto, None; Carl Rebhun, None; Stefan Ploner, None; Eric Moult, None; Eduardo Novais, None; A. Yasin Alibhai, None; Julia Schottenhamml, None; Ricardo Louzada, None; Nadia Waheed, Janssen, Regeneron, Genentech, Ocudyne (C), MVRF (F), Optovue, Nidek, Carl Zeiss Meditec (R); Andre Witkin, None; Caroline Baumal, Allergan (S), Genentech (S); Jay Duker, Carl Zeiss Meditec, OptoVue, and Topcon Medical Systems Inc. (C); James Fujimoto, Optovue Inc. (I), Royalties from intellectual property owned by MIT and licensed to Carl Zeiss Meditec Inc., Optovue Inc. (P); Daniela Ferrara, Genentech (E)
  • Footnotes
    Support  National Institutes of Health: 5-R01-EY011289-28 Air Force Office of Scientific Research: FA9550-15-1-0473, FA9550-10-1-0551
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 1578. doi:
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    • Get Citation

      Carlos Augusto Moreira Neto, Carl B Rebhun, Stefan B. Ploner, Eric M. Moult, Eduardo Amorim Novais, A. Yasin Alibhai, Julia Schottenhamml, Ricardo Louzada, Nadia Waheed, Andre J Witkin, Caroline R Baumal, Jay S Duker, James G Fujimoto, Daniela Ferrara; Analysis of Polypoidal Choroidal Vasculopathy Using Swept Source Optical Coherence Tomography Angiography with Variable Interscan Time Analysis. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1578.

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

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Abstract

Purpose : Optical coherence tomography angiography (OCTA) has been used to evaluate vascular lesions associated with polypoidal choroidal vasculopathy (PCV), but OCTA does not provide information about blood flow speed or turbulence. Recently, a novel OCTA algorithm termed variable interscan time analysis (VISTA) displays blood flow speed information in a color coded map of retinal vasculature. The aim of this study is to utilize VISTA to evaluate PCV lesions.

Methods : Seven eyes of 7 patients with a previous diagnosis of PCV were enrolled in this study. Volumetric OCTA of the retinal vasculature was obtained with a prototype 400kHz, 1050nm swept-source OCT (SS-OCT) system. The acquired OCT volumes were centered on the area containing the branch vascular network (BVN) and polyps as determined by indocyanine green angiography (ICGA). OCTA-VISTA was applied to the OCTA projections and the resulting blood flow speed information was mapped on a color-coded display.

Results : Five female and 2 male patients were evaluated. The mean age ± SD was 70 ± 9 years. SS-OCTA enabled detailed en face visualization of the BVN and polyps in 6 eyes. One eye showed motion artifact blocking the visualization of BVN and polyps. In one eye ICGA highlighted only one polyp and an adjacent area that demonstrated blocking due to hemorrhage. En face SS-OCTA of the same region revealed multiple clustered polyps. VISTA-OCTA color-coded images showed faster flow in the periphery of polyps and slower flow in the center of each polyp in five eyes (Figure 1). In two eyes, VISTA-OCTA was unable to provide more information than OCTA alone.

Conclusions : OCTA is useful in the identification of polyps in PCV and may provide insight into the disease process. VISTA-OCTA showed turbulent flow in the polyps, with the center showing slower flow than the periphery. In one case, en face OCTA was superior than ICGA in identifying polyps, suggesting that multimodal imaging with ICGA and OCTA may be more sensitive in detecting polyps in PCV lesions compared to ICGA on its own.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

Figure 1: A) ICGA of a PCV lesion cropped to a 3x3mm area. B) Corresponding OCTA. C) OCTA-VISTA of the same area. Arrows indicate two polyps. BVN is delineated by dashed line. Note turbulent flow inside the polyps. In OCTA-VISTA images, blue corresponds to slower, green to intermediate and red to faster blood flow.

Figure 1: A) ICGA of a PCV lesion cropped to a 3x3mm area. B) Corresponding OCTA. C) OCTA-VISTA of the same area. Arrows indicate two polyps. BVN is delineated by dashed line. Note turbulent flow inside the polyps. In OCTA-VISTA images, blue corresponds to slower, green to intermediate and red to faster blood flow.

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