First Author: C.Koutsiouki UK
Co Author(s): S. Sivaprasad
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To correlate the optical coherence tomography and optical coherence tomography angiography (OCT-A) features in RAP stage 1 and stage 2 in treatment-naive and in treated patients.
Retrospective case series analysis of patients from the medical retina department of Moorfields Eye Hospital
PARTICIPANTS: Patient diagnosed with stage 1 and stage 2 RAP lesion based on the clinical examination, SD-OCT, fluorescein angiography and if applicable indocyanine angiography underwent OCT-A. The OCT-A features were analyzed and correlated with the SD-OCT . MAIN OUTCOME MEASURES: The diagnostic capabilities of the SD-OCT to detect the presence of the RAP lesion, the intra/subretinal fluid (IRF/SRF), the pigment epithelium detachment (PED) were compared to the detection of the RAP lesion features on the OCT-A at the superficial capillary plexus (SCP), deep capillary plexus (DCP), outer retina, choriocapillaries (CC) and choroid levels.
A total of 24 eyes (17 patients, mean age 87.7 years range 78-99 years) were included, 15 eyes stage 1 and 9 eyes at stage 2. 13 patient were treatment naive and 11 under treatment with anti-VEGF monotherapy. In the treatment naive group the SD-OCT showed the presence of the RAP lesion as a hyper-reflective intraretinal material and this correlated with the ‘erosion sign’/‘flap sign’/‘kissing sign’ and corresponded to the flow detection in the OCT-A in the respective area. The OCT-A enface showed hyperreflectivity on the area corresponding to the RAP lesion and demonstrated the retinal-retinal anastomosis of the RAP lesion emerging form the DCP to the SCP and outer retina. In 5 cases in the treatment naive group, the OCT-A showed 2 RAP lesions of different stage, with one of the RAP lesion solely detected on the DCP. The OCT-A was also able to detect very early RAP lesion without being associated with IRF/SRF/PED on the SD-OCT in 5 treatment naive cases. In the treated group in 6 patients no RAP lesion was detected on the OCT-A and this correlated to no evidence of RAP lesion, IRF/SRF on SD-OCT.
SD-OCT and OCT-A were able to demonstrate the presence of the RAP lesion, the retinal-retinal anastomosis and the stage of the disease activity. Both can contribute to early diagnosis and the monitoring of treatment response .