Abstract
Purpose: :
Description and comparison of different OCT patterns of Occult CNV (O–CNV)
Methods: :
Series of 80 eyes of 110 patients presenting with O–CNV, recognized on SLO–Fluoresceine (FA) and indocyanine( ICG) angiogrphy (Heidelberg Retina Angiograph; Heidelberg Engineering, Heidelberg, Germany) completed with OCT examination Stratus Optical Coherence Tomography( OCT) examination (Humphrey Zeiss ) with at least an horizontal foveal cross–section and automatic 6 lines mapping. O–CNV lesions were identified as hyper–reflective areas in contact with pigment epithelium (RPE) band on OCT
Results: :
These O–CNV lesions were of 3452µ, +/– 340, on FA; these lesions were of 4648µ+/– 250, on ICG. RPE serous detachment (PED) was present on FA (35%). ICG–SLO allowed easier detection of PED (65%). On OCT horizontal cross section, the CNV extended on 3895µ +/–280.Intraretinal fluid accumulation with significant increase of thickness was observed in 75% of eyes. Intra–retinal cysts were detected in 37% and large central cyst in 10%. Subretinal fluid was recognized in 45% of eyes. RPE detachment (PED) was present in variable amount in 85% of eyes, either optically empty,( serous and bullous), at the border of the O–CNV(40%) or relatively flat, moderately reflective in fibro–vascular PED (30%). In 15%, RPE changes were moderate, with limited detachment and distortion,disruption, or fragmentation. The central mapping showed increased thickness at a mean of 354µ +/–17.
Conclusions: :
OCT was very effective in identification of PED, even small and relatively flat. Cross sectional OCT was critical for analysis of serous versus fibro–vascular PED and may, therefore, be valuable for prognostic value and guide for selection of adapted method of treatment.
Keywords: age-related macular degeneration • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • choroid: neovascularization