Fluorescein angiography and optical coherence tomography concordance for choroidal neovascularisation in multifocal choroidtis

Br J Ophthalmol. 2010 Nov;94(11):1506-8. doi: 10.1136/bjo.2009.159913. Epub 2010 May 14.

Abstract

Purpose: To compare the utility of fluorescein angiography (FA) and optical coherence tomography (OCT) as diagnostic adjuncts in evaluating symptomatic patients with choroidal neovascularisation (CNV) due to multifocal choroiditis (MFC).

Methods: Patients with CNV due to MFC were retrospectively evaluated in a consecutive fashion. Fundus photography, FA, OCT and biomicroscopy were used to establish the diagnosis. Primary outcome measures included CNV classification (type 1 or occult and type 2 or classic) location and the associated FA and OCT findings.

Results: Twenty eyes from 17 patients were included in the study. In 19 eyes (95%) the FA revealed CNV type 2; in one eye (5%) the type of CNV was indeterminate due to a subretinal haemorrhage that covered the lesion. Thirteen eyes had OCT imaging and all revealed hyper-reflectance beneath the neurosensory retina. However, only 53.8% revealed subretinal fluid (SRF) or intraretinal cystic abnormalities.

Conclusions: The CNV in MFC is virtually always type 2, or so-called classic CNV, with vessels beneath the neurosensory retina. Except when blocked by subretinal blood, the neovascularisation is clearly demonstrated by FA. In contrast, only 53.8% of these eyes showed clear evidence of actively proliferating neovascularisation on OCT. Therefore, eyes suspected of having CNV in MFC should be evaluated with FA.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Choroidal Neovascularization / diagnosis*
  • Choroidal Neovascularization / etiology
  • Choroidal Neovascularization / physiopathology
  • Choroiditis / complications*
  • Choroiditis / physiopathology
  • Female
  • Fluorescein Angiography / methods
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tomography, Optical Coherence / methods
  • Visual Acuity / physiology