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OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY OF CHORIORETINAL LESIONS DUE TO IDIOPATHIC MULTIFOCAL CHOROIDITIS

Zahid, Sarwar MD*; Chen, Kevin C. MD*; Jung, Jesse J. MD; Balaratnasingam, Chandrakumar MD, PhD*,‡,§,¶; Ghadiali, Quraish MD‡,§; Sorenson, John MD; Rofagha, Soraya MD, MPH; Freund, K. Bailey MD*,‡,§,**; Yannuzzi, Lawrence A. MD*,‡,§,**

doi: 10.1097/IAE.0000000000001381
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Purpose: To evaluate the spectrum of macular chorioretinal lesions occurring in idiopathic multifocal choroiditis using optical coherence tomography angiography (OCTA) to evaluate those showing neovascular flow.

Methods: This was a descriptive, retrospective study of 18 eyes of 14 patients with multifocal choroiditis. Macular lesions were characterized as subretinal pigment epithelium, subretinal, or mixed and evaluated during active and presumed inactive states of multifocal choroiditis. Correlations between structural optical coherence tomography and OCTA were performed. In select cases, correlations between OCTA, fluorescein angiography, and fundus autofluorescence were evaluated. In 5 eyes, quantitative measurements of neovascular lesions were compared at baseline and following intravitreal anti–vascular endothelial growth factor therapy.

Results: Mean patient age was 48 years (SD: 13.8; 86% women). Optical coherence tomography angiography flow signatures consistent with neovascularization were identified in 83% of eyes, including in 0% of subretinal pigment epithelium, 91% of subretinal, and 100% of mixed lesions. Lesions that did not demonstrate definitive signs of fluorescein angiography leakage were frequently found to have neovascularization using OCTA. There was no change in quantitative measurements of neovascular lesions after anti–vascular endothelial growth factor therapy (all tested variables P > 0.05).

Conclusion: Optical coherence tomography angiography may be a useful imaging modality for understanding the pathophysiology of multifocal choroiditis and monitoring its clinical course.

Optical coherence tomography angiography detected neovascular flow in 83% of the chorioretinal lesions occurring in eyes with idiopathic multifocal choroiditis but not in lesions confined to the subretinal pigment epithelium space.

*Department of Ophthalmology, New York University Langone Medical Center, New York, New York;

East Bay Retina Consultants, Oakland, California;

Vitreous Retina Macula Consultants of New York, New York, New York;

§LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, New York;

Department of Physiology and Pharmacology, Lions Eye Institute, University of Western Australia, Perth, Australia; and

**Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, New York.

Reprint requests: K. Bailey Freund, MD, Vitreous Retina Macula Consultants of New York, 460 Park Avenue, 5th Floor, New York, NY 10022; e-mail: kbfnyf@aol.com

Supported by The Macula Foundation, Inc.

K. B. Freund: Consultant to Optovue (Fremont, CA), Genentech (South San Francisco, CA), Optos (Marlborough, MA), Bayer HealthCare (Müllerstr, Berlin), and Heidelberg Engineering (Franklin, MA) (an honorarium for each); J. J. Jung: Consultant to Carl Zeiss Meditec (Dublin, CA) and Optos (Marlborough, MA); S. Rofagha: Consultant to Carl Zeiss Meditec (Dublin, CA). The remaining authors has no any conflicting interests to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.retinajournal.com).

Co-senior Authors: K. B. Freund and L. A. Yannuzzi.

© 2017 by Ophthalmic Communications Society, Inc.