Session Title: Free Paper Session 12: Imaging I
Session Date/Time: Friday 08/09/2017 | 14:30-16:00
Paper Time: 14:54
Venue: Room 111
First Author: : A.Tan SINGAPORE
Co Author(s): : K. Freund D. Simhaee L. Yannuzzi
To assess the utility of optical coherence tomography angiography (OCT-A) in differentiating vascularized versus non-vascularized pigment epithelial detachments (PEDs).
This was a single-centre, retrospective, cross-sectional, consecutive case series
Multimodal imaging excluding OCT-A was used to as a gold standard to classify the PEDs into non-vascularized or vascularized and this was compared to OCT-A findings. Cross-sectional OCT-A was assessed for the presence of abnormal flow within the PED and en face OCT-A was assessed for the presence of a vascular complex.
Sixty-four eyes of 49 patients with significant PEDs had multimodal imaging including OCT-A imaging; 18 eyes had non-vascularized and 46 eyes had vascularized PEDs. The rates of “diagnosis confirmed” for non-vascularized PEDs and vascularized PEDs was 61% and 76% respectively. “Diagnosis mismatched” cases of non-vascularized PEDs were due to projection artifacts or flow artifacts from highly hyper-reflective material while “diagnosis mismatched” cases of vascularized PEDs was associated with a lower rate of exudation and a higher rate of retinal pigment epithelial (RPE) tears. The subtypes or dimensions of the PED did not seem to significantly influence the accuracy of the OCT-A diagnosis.
Our proposed two-step approach of OCT-A interpretation, first using cross sectional OCT-A and then en face OCT-A may allow the differentiation between vascularized and non-vascularized PEDs; however, artifacts, regressed or inactive vascularization and the presence of RPE tears may be limitations to this technology. Increased awareness about potential artifacts and limitations of OCT-A amongst clinicians may help them interpret OCT-A with greater accuracy.