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Moises Enghelberg, Joud Chamchikh, Martha Henao, K V Chalam; Characterization of Idiopathic Polypoidal Choroidal Vasculopathy with Swept Source Optical Coherence Tomography Angiography. Invest. Ophthalmol. Vis. Sci. 2020;61(7):5247.
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© ARVO (1962-2015); The Authors (2016-present)
The PlexLite Elite Swept Source OCT-A is a novel imaging device which allows to image the retina and the choroidal vessels in an ultra widefield manner to better identify the pathology involving the mid and far retinal and choroidal periphery. In patients with IPCV, choroidal vascular dilation, polyps and branching choroidal networks are hallmarks in establishing the diagnosis. The use of a wide field imaging system allows for better characterization and diagnosis of subclinical lesions and aid in improvement of diagnosis and management of this complex disease
This is a prospective, observational study analyzing the data from patients examined by the retina service at Loma Linda University Eye Institute with an ophthalmological history consistent with IPCV. Four patients were identified to have ophthalmoscopic findings consistent with IPCV and spectrum disorders. Imaging was obtained using the PlexLite Elite Swept Source Optical Coherence Tomography Angiography. Montage images were obtained taking advantage of the device unique capabilities. 12mmx12mm images were captured. The caliper tool was used to measure the caliber of the choroidal vessels within the imaged area.
Among the 4 patients, the mean (SD) patient age was 57.75 (18.17) years. 3 men and 1 female were selected. Clear images of the polypoidal structures were obtained in 3 cases. The mean size of the pigment epithelial detachment (PED) in patients was 832.22 (582.42) μm. The mean size of the choroidal vessels (CV) in the aforementioned patient group was 481.33 (184.69) μm. In patients presenting with neurosensory detachments (ND), the mean widest base diameter of the detached area was 3988 (2471.77) μm. The mean size of the CV beneath the area of ND was 389.25 (51.9) μm. The mean value of the CV in the non involved fellow eye was 298.3 (51.87) μm. Using the flow map function PEDs presented profound flow void. All patients presented with disruption of the choriocapillaris.
In IPCV patients presenting with PED there is an increase in caliber of the external choroidal vessels. Patients presenting with PEDs consistently presented with changes in the perfusion flow map surrounding the PED. Polyps were easily identified beneath the PED area obviating the need for ICG. Regardless of the presentation of the disease in the IPCV spectrum, there was disruption of the choriocapillaris.
This is a 2020 ARVO Annual Meeting abstract.
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