Abstract
Abstract: :
Purpose:To evaluate OCT foveaolar extension of juxtafoveal visible non myopic choroidal newvessels (VCNV) before and after laser treatment. Methods: prospective 6 months study just before and 2 to 3 weks post krypton laser treatment examination of juxtafoveal VCNV with ETDRS visual acuity (VA), and indocyanin green angiography (FA and ICG) and OCT examinations. Fundus examination fixation point was studied before laser treatment and retrofoveolar VCNV were excluded. Results: 12 eyes with initial VA 20/400 to 20/32 with juxtafoveal VCNV on AF and ICG and macular hémorrhages (6 eyes) were studied. On OCT examination, juxtafoveal VCNV disclosed intense hyperreflectivity above or below the pigment epithelium (PE) layer with extension of VCNV larger in diameter on OCT than FA in all cases (mean 21%). Complete subfoveolar extension was found by OCT in 10 cases whereas eye fundus fixation point was spared. Krypton laser treatment was therefore performed in the 12 eyes. Post laser, VA was stable or improved in 11 eyes, AF showed a juxtafoveolar scar with complete occlusion of VCNV and OCT a complete disappearance of macular exsudation in all cases. However, 9 eyes presented with a subfoveolar PE layer hyperreflectivity and 3 eyes with foveolar thinning Conclusions: subfoveolar OCT hyperreflectivity of AF juxtafoveolar VCNV could represent a fibrous not yet neovascularized extension of VCNV as observed after surgical excision. OCT aspect of subfoveolar extension of VCNV should not prevent laser treatement of juxtafoveal VCNV based on AF and fixation point study.
Keywords: laser • retina • retinal neovascularization