Abstract
Purpose :
It has been reported that histopathologic findings of choroidal neovascularization (CNV) surgically extracted with a diagnosis of age-related neovascularization (AMD) contained fibrous tissues, vessels and retinal pigment epithelium (RPE). We also observed that the fibrovascular tissue was covered partially with the RPE in the extracted specimen which underwent intensive treatment of anti-vascular endothelial growth factor (VEGF) drugs (Mandai et al. New Eng J Med 2017). The aim of this study was to observe detailed structure of CNV using polarization-sensitive optical coherence tomography (PS-OCT) in combination with OCT angiography (OCTA).
Methods :
We observed CNV in 3 patients with AMD which contained mainly fibrous tissues using PS-OCT. Polarization scrambling of melanin and birefringence of fibrous tissues were visualized by entropy of the Jones matrix and local phase retardation, respectively. OCTA is overlaid with PS-OCT images to study the association between RPE and blood vessels.
Results :
High birefringence and scattered high entropy were observed in 2 eyes with CNV which contained large fibrous tissue left untreated for a long period (Fig. 1). High entropy was observed partially in double layers inside the CNV in 1 eye that underwent intensive treatment of anti-VEGF drugs. We further observed blood flows between and under these layers (Fig. 2), which resembled histopathologic findings of the surgically extracted specimen after intensive treatment of anti-VEGF drugs, possibly suggestive of pathologic history of repeated recurrences and remissions.
Conclusions :
In AMD, PS-OCT in combination with OCTA may help annotating structural components of CNV including RPE, fibrous tissues and vessels, which may provide an insight into the pathologic event during the disease progress.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.