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Justin Yamanuha; The Utility of Optical Coherence Tomography Angiography (OCT-A) in Vitelliform Macular Dystrophy. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2834.
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© ARVO (1962-2015); The Authors (2016-present)
Optical coherence tomography angiography (OCT-A) is a rapid, non-invasive imaging modality which allows segmented analysis of various retinal and choroidal layers. OCT-A has been used to describe various macular, retinal vascular, and choroidal processes but not studied extensively in vitelliform macular dystrophy. This retrospective review was performed to categorize the various manifestations of vitelliform macular dystrophy by OCT along with OCT-A.
A retrospective case review was conducted in the Medical Retina Clinic at the Mayo Clinic Health System in La Crosse, Wisconsin for patients who had both structural OCT and OCT-A imaging with the diagnosis of Vitelliform Macular Dystrophy. Patients were excluded if they did not have imaging with both methodologies on the same day on at least two visits. Institutional Review Board (IRB) exemption was granted due to the de-identified retrospective nature of this investigation.
Three different imaging phenotypes of vitelliform macular dystrophy were identified by pairing OCT with OCT-A:1) Structural vitelliform signal on OCT and structural vitelliform signal on OCT-A (classic Vitelliform Lesion)2) Sub-foveal subretinal hypo-reflective area on structural OCT with structural signal on OCT-A (resolving Vitelliform Lesion)3) Sub-foveal subretinal hypo-reflective area on structural OCT with flow signal on OCT-A (Vitelliform lesion with associated type 2 choroidal neovascularization)
Co-utilization of OCT with OCT-A helped to identify and classify three imaging phenotypes in Vitelliform Macular Dystrophy without the need for invasive dye-based angiography. OCT-A can help to distinguish structural vitelliform signals from type 2 choroidal neovascularization and is invaluable in patients with sub-foveal subretinal hypo-reflective areas on structural OCT. These modalities should be used in concert with fundus auto-fluorescence in patients with typical vitelliform lesions and those in whom choroidal neovascularization may be suspected.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Figure 1. Sub-foveal subretinal hypo-reflective area with round, well circumscribed structural vitelliform signal in avascular outer retina on OCT-A
Figure 2. Sub-foveal subretinal hypo-reflective area with irregular vascular flow signal corresponding to type 2 choroidal neovascularization in avascular outer retina on OCT-A
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