Optical Coherence Tomography In Myopic Choroidal Neovascularization Treated With Photodynamic Therapy.

Abstract

Abstract: : Purpose:To evaluate and define the optical coherence tomography (OCT) morphological characteristics of choroidal neovascularization in high myopia in different stages of activity. Methods:Twenty one eyes of 19 patients with myopic choroidal neovascularization (CNV) in different phases of photodynamic treatment with verteporfin were classified, based on fundoscopic and angiographic findings, in active, scar or atrophic stages. OCT was performed in these eyes and the morphological characteristics were identified for each stage. Results: In the eyes classified with active stage CNV (6), OCT displayed a highly reflective dome–like elevation above the retinal pigment epithelium (RPE), with scarce intraretinal fluid associated in 3 cases (50%). Among eyes with CNV in the scar stage (11), the membrane showed high reflectivity, especially on its anterior surface, with optical shadowing of the structures. In the atrophic stage (4 eyes) the CNV seemed flat with diffuse increase in choroidal reflectivity around the lesion, consistent with chorioretinal atrophy. Retinal thickness above the neovascular lesion showed no relation with its activity, while the thickness of the CNV itself seemed to increase with its activity. CNV with a pattern of pseudo–duplication of the RPE was found in 5 eyes. Conclusions:OCT demonstrated characteristic patterns at each stage of myopic neovascularization. Retinal thickness above the neovascular lesion showed no relation with its activity, unlike what has been described for CNV secondary to age–related macular degeneration. This is the first report, as far to our knowledge, of a pattern of pseudo–duplication of the RPE in myopic CNV. Although providing most valuable information in the study of myopic CNV, OCT alone may not be sufficient in evaluating the activity of this particular kind of neovascularization.

Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • choroid: neovascularization • myopia