Unique Features of Choroidal Vasculature In Patients with Choroidal Neovascular Membranes

Abstract

 

Purpose

 

High-resolution spectral domain optical coherence tomography (SD-OCT) has revolutionized the detailed imaging of retinal anatomy and has become an important clinical tool in a variety of retinal disorders. SD-OCT combined with enhanced-depth imagining (EDI) has allowed for similar level of resolution for examining the anatomy of the choroid. The purpose of this study is to evaluate the choroidal vasculature in patients with active choroidal neovascularization (CNV) and to determine possible changes in the choroid in response to anti-vascular endothelial growth factor (anti-VEGF) treatment.

 

Methods

 

Seventeen eyes of 14 consecutive patients with CNV who underwent SD-OCT imaging with the Heidelberg Spectralis were included in this retrospective analysis. SD-OCT images with sufficient resolution to allow for evaluation of the choroidal vasculature were analyzed. B-scans of the choroidal vascular structure immediately underneath the CNV were evaluated.

 

Results

 

Forty-one percent of eyes (7 of 17) included in the study had CNV secondary to myopia; in 59% of eyes (10 of 17), the CNV was due to exudative age-related macular (AMD). The mean follow-up period was 13 months. Independent analysis of choroidal vasculature by 2 masked graders revealed that in all 17 eyes, there was at least one large caliber choroidal vessel either at the border or directly underneath the CNV (see figure). There were no significant changes noted in the choroidal anatomy in response to anti-VEGF treatment.

 

Conclusions

 

SD-OCT demonstrates the presence of large caliber choroidal vessels in association with CNV in patients with CNV due to AMD and myopic degeneration. These vessels do not appear to change in response to anti-VEGF therapy. The clinical significance of these findings will undoubtedly require larger prospective studies.

 

 

Keywords: 453 choroid: neovascularization • 550 imaging/image analysis: clinical • 412 age-related macular degeneration