Three dimensional vascular imaging of polypoidal choroidal vasculopathy by Doppler optical coherence tomography

Abstract

 

Purpose

 

To investigate the 3-D architecture of polypoidal lesions in polypoidal choroidal vasculopathy (PCV) non-invasively using Doppler optical coherence tomography (OCT). To evaluate the clinical usefulness of Doppler OCT for the assessment of therapeutic effect for PCV.

 

Methods

 

Fifteen eyes of 15 patients with treatment-naïve PCV were prospectively studied. 3-D vascular flow imaging (OCT angiography) was obtained using 1-mm swept source Doppler OCT, and compared with indocyanine green angiography (ICGA) images. Therapeutic effect of three consecutive intravitreal aflibercept injection was evaluated with reduction rate of polypoidal lesions in ICGA and Doppler OCT images.<br /> Reduction rate = (1 − area after treatment∕area before treatment)×100

 

Results

 

In Doppler OCT images, polypoidal lesions could be clearly detected at the corresponding location of lesions in the ICGA images. By the impervious feature to dye leakage, Doppler OCT imaging could identify the more detailed vascular structure in the polypoidal lesions. Polypoidal lesions in Doppler OCT images were consisted of focal aneurysmal dilation in the vascular network. Polypoidal lesions were located in the retinal pigment epithelial detachment in 13 eyes, in the choroid in one eye, and in both the retinal pigment epithelial detachment and the choroid in one eye. Mean area of polypoidal lesions in ICGA images (0.13 mm²) was significantly larger than Doppler OCT images (0.04 mm²)(P = 0.0007). After the intravitreal injection of aflibercept, areas of polypoidal lesions in ICGA images were decreased in 14 of 15 eyes, while Doppler OCT could clearly detect this therapeutic effect in all eyes. Mean reduction rates were 65.8 % in ICGA images and 66.6 % in Doppler OCT images. Reduction rate in Doppler OCT images was significantly correlated with ICGA images (R² = 0.82, P = 0.0007).

 

Conclusions

 

Doppler OCT clearly detected 3-D fine vascular structure at polypoidal lesions in PCV. Doppler OCT might be utilized for the non-invasive diagnosis and evaluation of therapeutic effects of PCV.