Biomarker assessment for CNV development prediction in multifocal choroiditis (MFC) and punctate inner choroidopathy (PIC): A large, longitudinal, multicenter study on patients with MFC and PIC using an artificial intelligence-based OCT fluid and biomarker detector

Abstract

Purpose : Secondary choroidal neovascularization (CNV) represents the major cause of vision loss in idiopathic MFC and PIC. This study assessed potential biomarkers on OCT to predict the development of CNV using an artificial intelligence (AI)- based software.

Methods : In this multicenter, longitudinal retrospective study, sequential OCTs of MFC and PIC patients were analyzed by an AI-software (Discovery® OCT Biomarker Detector, RetinAI AG, Switzerland). Different morphological biomarkers, volumes of different fluid and lesion compartments as well as layer thicknesses were assessed and AI-based segmentation was manually corrected for all OCT scans, as needed. Data were compared between MFC and PIC and between eyes with and without CNV development. Regression analyses and ML approaches were used to identify the predictive biomarkers for CNV development.

Results : Overall 88 patients were included (PIC: n=55, MFC: n=33, females=66, mean age=47.9 (± 11.8 SD)). The mean follow-up (F/U) period was 5.7± 1.3 yrs and the average spherical equivalent (SE) in the study population was -3,85±4.92 diopters (D). The mean baseline Snellen best-corrected visual acuity (BCVA) was 0.94± 0.48 and did not significantly change during F/U (last F/U visit 0.96 ± 0.47, p=0.66). During the F/U, respectively 67.3 % of the patients with PIC and 60.6 % with MFC developed CNV (p=0.000). The average chorioretinal lesion volumes were significantly larger in MFC compared to PIC (192.8 ± 231 nL vs. 45.8±100.6 nL, p≤ 0.001). Eyes developing CNV had significantly greater lesion volumes than patients without CNV both in PIC and MFC at baseline (126.1 nL ± 18.5 vs 12.0 nL ± 3.0, p=0.001) and during the F/U period (125.0± 37.9 nL vs 9.4±3.1 nL, p≤ 0.001).

Conclusions : Lesion volume is an important predictive biomarker for future secondary CNV development in eyes with PIC or MFC. This finding highlights the importance of evaluation of OCT volumetric data in both the diagnostic and prognostic processes in patients with MFC/PIC.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

Comparison of the prevalence between patients CNV+ and patients CNV- in PIC and MFC subgroups

 

Average lesion size in patients CNV+ and patients CNV-