Abstract
Purpose: :
To investigate findings from fundus fluorescein angiography (FFA) and spectral domain optical coherence tomography (SD-OCT) in eyes with active inflammatory choroidal neovascularisation (CNV).
Methods: :
A retrospective analysis of visual acuity, FFA and SD-OCT findings of consecutive patients with inflammatory CNV was performed. FFA was evaluated for location, type of lesion, presence of haemorrhage, serous pigment epithelial detachment (PED), atrophy and fibrous tissue. SD-OCT was evaluated for the presence of intraretinal (IRF), subretinal fluid (SRF), PED and subretinal tissue.
Results: :
Twenty eyes of 20 patients with inflammatory CNV were analysed. Male to female ratio was 3/17. Mean age was 39,3 years and mean visual acuity was 6/12 (range 3/60 to 6/5). 16 patients had punctate inner choroidopathy (70%), 3 patients had multifocal choroidopathy (15%), one patient had sarcoid related uveitis (5%) and one patient Vogt-Koyanagi Harada disease (5%). In 7 eyes the CNV was subfoveal (35%), in 9 eyes juxtafoveal (45%), in 3 eyes extrafoveal (15%), and one eye had peripapillary CNV (5%). Classic CNV was detected in 16 eyes (80%), predominantly classic in 2 eyes (10%), minimally classic in 1 eye (5%) and one eye had occult CNV (5%). Clinically evident haemorrhage was observed in 4 eyes (20%) and 8 eyes (40%) had atrophic areas adjacent to the CNV. 5 eyes (25%) had staining scars in late frames of the FFA and no serous PED was observed. OCT scan revealed the presence of IRF and SRF in 15 eyes (75%) and 14 eyes (70%) respectively and CMO was detected in 3 eyes (15%). PED was evident in 5 eyes (25%) and subretinal tissue in 18 eyes (90%).
Conclusions: :
The anatomic features of inflammatory choroidal neovascular membrane differ from those seen in CNV occurring secondary to AMD. In particular, these lesions are often classic or predominantly classic on FFA, and are associated with minimal evidence of PED. Awareness of these differences, and evaluation of novel OCT markers such as subretinal tissue, may aid assessment of disease activity in such patients, and thus improve retreatment protocols.
Keywords: choroid: neovascularization • inflammation • imaging/image analysis: clinical