Posters

OCT-Angiography in myopic CNV

Poster Details

First Author: K.RĂ¼ther GERMANY

Co Author(s):    K. Wehrmann   N. Feucht   C. Lohmann   M. Maier                    

Abstract Details



Purpose:

For diagnosis of myopic choroidal neovascularisation (mCNV) in eyes with high myopia fluorescein angiography (FAG) is the current gold standard. Due to the specific anatomy of highly myopic eyes, high-Quality Images are often difficult to generate, and challenging with time-sensitive recording techniques (FAG). The purpose of this essay was to compare mCNV imaging with FAG with optical coherence tomography angiography (OCT-A) and describe the advantages and disadvantages.

Setting:

Department of Ophthalmology, Klinikum Rechts der Isar, Technical University of Munich

Methods:

14 eyes with mCNV were examined on the same day with FAG and OCT-A. Then the recordings were compared with one another and compared according to the following criteria: quality of imaging, mCNV detectable, mCNV vessels can be demarcated, activity can be assessed (leakage in FAG vs. flow in OCT-A, aided by SD-OCT).

Results:

Of the 14 eyes, 2 could not be used in OCT-A due to poor imaging quality. In these cases, snapshot of leakage were possible during late phase FAG. In 10 eyes, a diffuse CNV complex with leakage was visible in FAG and corresponding areas with increased flow were visible in 9 eyes with OCT-A. In one case, the CNV complex was very small and could only be determined clearly in late phase FAG due to leakage, while in OCT-A we were not able to separate the CNV network from the physiological choroid flow. Demarcated vessels were only visible in one case with FAG versus 6 in OCT-A. Signs of activity were detectable in FAG with all 14 eyes. In OCT-A pathological flow detection was measurable in 11 cases and corresponded to FAG findings.

Conclusions:

OCT-A allows an accurate assessment of mCNV in patients with high myopia, often superior in the presentation of blood vessel networks compared to FAG. Since OCT-A allows a layered presentation of the retinal vessels, in myopic eyes with large atrophy areas, clear imaging without choroid blooming is possible. In 11 out of 14 cases OCT-A allowed a precise diagnosis, with similar relevance for therapy decisions. In the future the detailed vascular demarcation provided by OCT-A might be a precise and fast follow-up parameter for the diagnosis of mCNV. However OCT-A alone does not appear to be a sufficient diagnostic tool in all cases of mCNV and thus should be used in combination with SD-OCT and FAG in challenging cases. Technical advances as well as the unlimited ability to repeat acquisition can partially compensate for these disadvantages.

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