Abstract
Purpose :
To report cases of CNV detected with OCT-A in patients diagnosed with CSC and to analyze the response of anti-VEGF injections
Methods :
We retrospectively evaluated the fundus, FA, ICGA, OCT and OCT-A(Zeiss Elite, SS-OCTA) of consecutive 65 chronic CSC patients. Outer retina choriocapillaris(ORCC) slab and choriocapillaris(CC) slab was used to detect CNV. Anti-VEGFs were injected in cases of CNV detected with OCT-A. The response of anti-VEGF was evaluated with B-scan OCT and OCT-A.
Results :
30 of 65 consecutive chronic CSC patients had irregular PEDs detected with B-scan OCT. 8 of 30 irregular PEDs had CNV detected with OCT-A and these CNVs had not been diagnosed with FA, ICGA and B-scan OCT. There were no polyps in ICGA, So these cases must be pachychoroid Neovasculopathy(PNV). 7 of 8 had relatively thick choroid and 1 had thin choroid with pachyvessel (case 5). Anti-VEGF injections successfully reduced subretinal fluid in all cases, but 6 of 8 patients required repeated anti-VEGF injections and PDT was done in 1 recurrent case. The size and shape of CNV was not much changed with anti-VEGF injections, but in 1 PDT case, the size of CNV was decreased. In 2 patients, small subretinal hemorrhage developed after focal laser treatment. Focal laser might rupture Bruch membrane to induce new CNV or to activate the preexisting small CNV.
Conclusions :
OCT-A was the only imaging modality to detect PNV and these lesions were well responded with repeated anti-VEGF injections with B-scan OCT monitoring. Focal laser should be performed with caution, especially in juxtafoveal lesion. In recurrent cases, PDT might be considered.
This is a 2020 ARVO Annual Meeting abstract.