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Carlos Augusto Moreira Neto, Carl B Rebhun, Stefan B. Ploner, Eric M. Moult, Eduardo Amorim Novais, A. Yasin Alibhai, Julia Schottenhamml, Ricardo Louzada, Nadia Waheed, Andre J Witkin, Caroline R Baumal, Jay S Duker, James G Fujimoto, Daniela Ferrara; Analysis of Polypoidal Choroidal Vasculopathy Using Swept Source Optical Coherence Tomography Angiography with Variable Interscan Time Analysis. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1578.
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© ARVO (1962-2015); The Authors (2016-present)
Optical coherence tomography angiography (OCTA) has been used to evaluate vascular lesions associated with polypoidal choroidal vasculopathy (PCV), but OCTA does not provide information about blood flow speed or turbulence. Recently, a novel OCTA algorithm termed variable interscan time analysis (VISTA) displays blood flow speed information in a color coded map of retinal vasculature. The aim of this study is to utilize VISTA to evaluate PCV lesions.
Seven eyes of 7 patients with a previous diagnosis of PCV were enrolled in this study. Volumetric OCTA of the retinal vasculature was obtained with a prototype 400kHz, 1050nm swept-source OCT (SS-OCT) system. The acquired OCT volumes were centered on the area containing the branch vascular network (BVN) and polyps as determined by indocyanine green angiography (ICGA). OCTA-VISTA was applied to the OCTA projections and the resulting blood flow speed information was mapped on a color-coded display.
Five female and 2 male patients were evaluated. The mean age ± SD was 70 ± 9 years. SS-OCTA enabled detailed en face visualization of the BVN and polyps in 6 eyes. One eye showed motion artifact blocking the visualization of BVN and polyps. In one eye ICGA highlighted only one polyp and an adjacent area that demonstrated blocking due to hemorrhage. En face SS-OCTA of the same region revealed multiple clustered polyps. VISTA-OCTA color-coded images showed faster flow in the periphery of polyps and slower flow in the center of each polyp in five eyes (Figure 1). In two eyes, VISTA-OCTA was unable to provide more information than OCTA alone.
OCTA is useful in the identification of polyps in PCV and may provide insight into the disease process. VISTA-OCTA showed turbulent flow in the polyps, with the center showing slower flow than the periphery. In one case, en face OCTA was superior than ICGA in identifying polyps, suggesting that multimodal imaging with ICGA and OCTA may be more sensitive in detecting polyps in PCV lesions compared to ICGA on its own.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
Figure 1: A) ICGA of a PCV lesion cropped to a 3x3mm area. B) Corresponding OCTA. C) OCTA-VISTA of the same area. Arrows indicate two polyps. BVN is delineated by dashed line. Note turbulent flow inside the polyps. In OCTA-VISTA images, blue corresponds to slower, green to intermediate and red to faster blood flow.
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