Purpose:
To determine the incidence of atypical Choroidal Neovascularization (CNV) in patients with Retinal Pigmentary epithelium detachment (RPED), as well as to know the central macular thickness, to identify the morphological changes by means of combined Fluorescein - Indocyanine green angiography (FA/ICG) and Spectral domain OCT (SD-OCT), to correlate the size of the RPED with the presence of Atypical CNV, and to correlate the findings with Best corrected visual Acuity (BCVA).
Methods:
Descriptive, cross-sectional and observational study. Six patients with diagnosis of REPD associated to CNV were included, the diagnosis was made by means of clinical examination with visual acuity tests, biomicroscopy, and fundus exam, to whom combined FA/ICG angiography and SD-OCT were performed with the Spectralis HRA-OCT (Heidelberg Engineering). Examination included high resolution FA/ICG videoangiography, FA/ICG image and combined FA/SD-OCT and ICG/SD-OCT with central linear and 25°x25° 30 frame macular cube technique acquisition. Images were analyzed by means of direct observation of the fluorescence patterns (searching for arteriolized membranes, polypoidal choroidal vasculopathy, or Retinal angiomatous proliferation) as well as observation of the central retinal architecture. Measurement of central retinal thickness and REPD thickness with auto segmentation was also performed. Findings obtained were correlated with BCVA.
Results:
Thirteen eyes (nine patients) with diagnosis of RPED associated to CNV were evaluated; 1 eye (7.6%) had arteriolized pattern of the CNV, 7 eyes (53.8%) had polypoidal pattern of CNV, and 5 eyes (38.4%) did not have any characteristic pattern of the CNV. Mean BCVA was 20/200, mean central thickness was 350µ, and the mean RPED thickness was 230µ.
Conclusions:
The present study shows angiographic specific patterns of the Atypical CNV in 8 of the 13 studied eyes (61.5%), which corresponded with thicker RPED and lower BCVA, although we found a consistent polypoidal choroidal vasculopathy angiographic pattern. A larger population of patients should be evaluated.
Keywords: choroid: neovascularization