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Oudy Semoun, Florence Coscas, Gabriel J Coscas, Eric H Souied; En face enhanced depth imaging optical coherence tomography of polypoidal choroidal vasculopathy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3837.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze retinal and choroidal changes in polypoidal choroidal vasculopathy (PCV) using en face enhanced depth imaging (EDI) spectral-domain optical coherence tomography (SD-OCT).
Thirty consecutive patients presenting with PCV were included in this retrospective and descriptive study at the Centre Hospitalier Intercommunal de Créteil (Créteil, France). All patients were examined using SD OCT with EDI, fluorescein angiography (FA) and indocyanine green angiography (ICGA). The 3D reconstruction of 197 transverse sections with SD OCT at 30 μm intervals, each comprised of nine averaged B-scans, provided a virtual macular brick through which 496 sections in the coronal plane resulted in a C-scan ("En face" OCT image). En face imaging (C-scans) were compared with ICGA and FA images.
Thirty eyes of 30 consecutive patients were studied. In all 30 eyes, ICGA and FA allowed visualization of the PCV. Polyps were detected easily in all cases with en face OCT, usually more numerous than with ICGA, as roundish structures visible deeper than pigment epithelium layer, and attached to its posterior face. Hyperreflective dots were visible in most cases with the retinal layers, associated to a well-defined dark area suggesting serous exudation. The abnormal choroidal network was rarely clearly identified, even when well detected with ICGA. At the Bruch membrane level, polyps were associated to a localized back shadowing, and were no more visible at the choriocapillaries layer. Large choroidal vessels were visible, mainly at the polypoidal lesion periphery, and not directly behind.
En face OCT imaging using SD OCT is an easy, reproducible, non-invasive and effective tool to vizualize and to understand retinal and choroidal changes PCV. It provides complementary morphological information, describes new semiological entities and might substitute other exams in the future, without dye injection.
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