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Seung-Young Yu, Jae Min Kim, Sung Rae Noh, Kiyoung Kim, Kunho Bae, Eung-Suk Kim; Changes of OCTA Findings after Treatment in Polypoidal Choroidal Vasculopathy. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3222.
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© ARVO (1962-2015); The Authors (2016-present)
The purpose of this study was to evaluate the change of the lesion on OCTA following treatment in patients with polypoidal choroidal vasculopathy (PCV).
Retrospective medical record was reviewed in 16 eyes with treatment-naïve PCV, seen at Kyunghee University Hospital between May 2016 and January 2017. All patients underwent ophthalmic examination such as ICGA, OCT, OCTA and fundus photography. Patients diagnosed with PCV were treated with monotherapy (Intravitreal ranibizumab or aflibercept injection) or combination therapy (Photodynamic therapy and intravitreal ranibizumab injection). PDT was performed only in the polyp region, not containing BVN. The ratio of polyp regression and recurrence were analyzed.
Sixteen eyes of 16 patients (11 male, 5 female) were included in the study. Average age was 68.43±9.07 years. The number of each treatment were 11 eyes for monotherapy and 5 eyes for combination therapy. At baseline, the polypoidal lesions detected in ICGA were found in 11 eyes (69%) by OCTA, of which hypoflow halo form was in 4 eyes (25%) and hyperflow form was in 7 eyes (44%). The BVN were detected in 7 eyes (44%) by ICGA and in 12 eyes (75%) by OCTA. Among the 7 eyes of hyperflow that cleary showed the appearance of polyp on OCTA, the decrease of size and disappearance of polypoidal lesion in 6 months after therapy was detected respectively in 3 eyes (43%) and in 3 eyes (43%). The decrease of size of BVN in 6 months after therapy was detected in 8 eyes (67%). The recurrence of polypoidal lesion and BVN in 6 months after therapy was detected each in 1 eyes (14%) and in 4 eyes (33%). Of the 4 eyes with recurrence of BVN, 3 eyes were recurred within 2 months after 3 consecutive monotherapy and 1 eye was recurred at 4 months after combination therapy and additional 2 consecutive intravitreal injection.
The OCTA is a noninvasive and good imaging tool for detecting vascular changes in PCV. Branching vascular networks showed more clearly on OCTA than on ICGA. On the other hand, polypoidal lesions were detected in variable patterns (hyperflow or hypoflow halo) on OCTA and showed more clearly on ICGA than on OCTA. Although the OCTA is difficult to use as primary tool to diagnose PCV, it can be a very effective method for observing post-treatment progression in patients with PCV.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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