Purpose:
To evaluate spectral-domain optical coherence tomography (SD-OCT) findings that predict angiographic leakage in myopic choroidal neovascularization (MCNV).
Methods:
SD-OCT and fluorescein angiography (FA) images of 79 eyes of 77 patients obtained with Heidelberg-Spectralis were retrospectively analyzed. Eight eyes were naive and 71 eyes were previously treated with photodynamic laser, Bevacizumab or both. FA images were analyzed to assess the presence of leakage. SD-OCT images were analyzed to identify the presence of fluid including intraretinal cystic spaces (ICS), retinal pigment epithelium detachment (PED) and neurosensory detachment (NSD). The presence of intraretinal hyperreflective flecks, the reflectivity of the MCNV and its boundary definition were evaluated as well. Both the association and the sensitivity, specificity, and both positive and negative predictive values of SD-OCT findings compared with FA leakage were calculated. Fisher exact test was used to calculate significant differences between FA leaky and non-leaky groups for every specific pattern of fluid or other abnormalities in OCT.
Results:
A statistically significant association between SD-OCT findings and FA leakage was found for eyes that displayed fluid, NSD, intraretinal flecks, and low reflectivity or undefined boundaries of MCNV, and not for ICS. Sensitivity and specificity for SD-OCT findings were, respectively: 72% and 60% for fluid; 38% and 92% for NSD; 38% and 62% for ICS; 51% and 77% for intraretinal flecks; 72% and 85% for undefined boundaries of MCNV; and 61% and 75% for low reflectivity of MCNV. PED wasn't found in any patient. Positive and negative predictive values were, respectively, 64% and 68% for fluid; 83% and 61% for NSD; 50% and 52% for ICS; 69% and 62% for intraretinal flecks; 82% and 75.5% for undefined boundaries of MCNV; and 70% and 67% for low reflectivity of MCNV.
Conclusions:
Except for NSD specificity, all the SD-OCT findings in FA leaky MCNV are neither sensitive nor specific. None of the OCT findings was predictive of angiographic leakage. Addictional studies with larger and more selective samples are needed to evaluate the role of SD-OCT in identifing active MCNV.
Keywords: choroid: neovascularization • myopia • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)