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CHARACTERIZATION AND DIFFERENTIATION OF POLYPOIDAL CHOROIDAL VASCULOPATHY USING SWEPT SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY

Cheung, Chui Ming Gemmy FRCOphth*,†,‡; Yanagi, Yasuo PhD*,†; Mohla, Aditi FRCS(Ophth)*; Lee, Shu Yen FRCS(Ed)*,†; Mathur, Ranjana FRCS(Ed)*,†; Chan, Choi Mun FRCS(Ed)*,†; Yeo, Ian FRCS(G)*,†; Wong, Tien Yin FAFPHM*,†,‡

doi: 10.1097/IAE.0000000000001391
Original Study

Purpose: To determine the correlation and agreement between swept-source optical coherence tomography angiography (SS-OCT-A) with fluorescein angiography (FA), indocyanine green angiography (ICGA) and spectral domain OCT (SD-OCT) in characterizing polypoidal choroidal vasculopathy (PCV) and in differentiating eyes with typical age-related macular degeneration (t-AMD).

Methods: This study included 32 and 54 eyes with t-AMD and PCV, respectively, who underwent SS-OCT-A, SD-OCT, fluorescein angiography, and indocyanine green angiography. The images from these four techniques were compared.

Results: On SS-OCT-A, flow signals with vascular network configuration were detected in 81.2% and 77.8% of eyes with t-AMD and PCV, respectively. 40.4% of polyps were detected as flow signals with polypoidal configuration. Compared with indocyanine green angiography, SS-OCT-A had sensitivity and specificity of 83.0% and 57.1%, respectively, for vascular network, and 40.5% and 66.7% for polyps. Longitudinal changes were in agreement between SS-OCT-A and SD-OCT in 90% of eyes. 88.2% of eyes with dry retina on SD-OCT had persistent vascular net on SS-OCT-A. In two cases with reactivation of PCV, SS-OCT-A was more sensitive at detecting recurrence than SD-OCT.

Conclusion: Swept-source optical coherence tomography angiography is effective at detecting vascular network that correlate to conventional angiography in eyes with t-AMD and PCV. Swept-source optical coherence tomography angiography is inferior to indocyanine green angiography in detecting polyps and cannot replace indocyanine green angiography for differentiating PCV from t-AMD; however, SS-OCT-A may be more sensitive than SD-OCT in detecting early recurrence.

Swept Source OCT-A has high sensitivity for detecting vascular network and moderate sensitivity for detecting polyps. Changes in flow signal after treatment may reflect response and recurrence risk.

*Medical Retina Service, Singapore National Eye Centre, Singapore;

Medical Retina Service, Singapore Eye Research Institute, Singapore; and

Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Reprint requests: Chui Ming Gemmy Cheung, FRCOphth, Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore 168751; e-mail: gemmy.cheung.c.m@snec.com.sg

Supported by National Medical Research Council grant NMRC/NIG/1003/2009 and BMRC Grant No. 10/1/35/19/671.

None of the authors has any conflicting interests to disclose.

© 2017 by Ophthalmic Communications Society, Inc.