Abstract
Purpose :
Optical Coherence Tomography Angiography (OCT-A) has emerged as a valuable adjunctive imaging modality for the detection of choroidal neovascular membranes (CNVM). The goal of this study is to investigate the utility of OCT-A for the detection of inflammatory CNVM (i-CNVM) and monitoring their response to treatment.
Methods :
A retrospective review of patients with a diagnosis of uveitis and associated i-CNVMs based on clinical exam and OCT (CIRRUS, Carl Zeiss Meditec, Inc, Dublin, OH) was conducted. 6 × 6-mm SD-OCTA (CIRRUS AngioPlex, Carl Zeiss Meditec, Inc, Dublin, OH) or 6 × 6-mm swept-source OCTA (Plex Elite 9000; Carl Zeiss Meditec, Inc) images were acquired and the outer retina to choriocapillaris (ORCC) slab evaluated by two graders for the presence of i-CNVM. Follow up images were qualitatively assessed in order to determine if regression of i-CNVM occurred following treatment.
Results :
Thirteen eyes (punctate inner choroidopathy (n=4), persistent placoid maculopathy (n=2), sarcoid uveitis (n=2), tuberculous choroiditis (n=1), birdshot chorioretinopathy (n=1), syphilitic uveitis (n=1), serpiginous choroiditis (n=1) and idiopathic panuveitis (n=1)) with i-CNVM and OCT-A images were identified. I-CNVM was detected on OCT-A in 11/13 eyes (84.6%). Treatment for i-CNVM included intravitreal bevacizumab (n=1), intravitreal ranibizumab (n=2), intravitreal aflibercept (n=8), subtenon triamcinolone acetonide (n=2) and intravitreal dexamethasone implant (n=2). Of these 11 eyes with detectable i-CNVM, 7 (63.6%) had a new diagnosis of i-CNVM. Mean best corrected visual acuity post-treatment improved from 0.68 (range 0.1-1.5) to 0.57 (-0.2-1.5) (p=0.08). Notably, 10 eyes (90.9%) demonstrated regression in i-CNVM area on OCT-A with treatment and of those 10 eyes, 4 (40.0%) showed complete regression in i-CNVM with treatment.
Conclusions :
Our results show that OCT-A is an effective modality for detecting i-CNVM and that visible regression of the CNVM is apparent in the majority of cases following treatment.
This is a 2021 ARVO Annual Meeting abstract.