Optical coherence tomographic angiography of choroidal neovascularization ill-defined with fluorescein angiography

Br J Ophthalmol. 2017 Jan;101(1):45-50. doi: 10.1136/bjophthalmol-2016-309094. Epub 2016 Dec 2.


Purpose: To evaluate the morphological structure of ill-defined choroidal neovascularisation (CNV) with traditional fluorescein angiography (FA) compared with optical coherence tomographic angiography (OCTA).

Methods: A retrospective case series study of 11 eyes with ill-defined CNV on FA was performed. Eyes were scanned with commercially available spectral-domain optical coherence tomography (OCT) (70 000 A-scans/s). The split-spectrum amplitude-decorrelation angiography (SSADA) algorithm was used to distinguish blood flow from static tissue. En face OCT angiograms were compared with FA.

Results: Eleven cases of ill-defined CNV on FA were identified from 10 study participants. Mean age of the participants was 74.5±6.8 years. Six cases had late leakage from undetermined source (LLUS) and five had fibrovascular pigment epithelial detachment (FVPED). Combining cross-sectional structural OCT with OCT angiograms, all cases were found to have type 1 CNV that corresponded to occult CNV with FA. In all cases of occult CNV on FA, distinct vascular structures were visible with OCTA in the outer retinal/retinal pigment epithelium slab. The mean CNV vessel area was 2.61±3.65 mm2. The mean CNV vessel area in cases with FVPED was larger than that in cases with LLUS (4.69±4.72 mm2 compared with 0.85±0.90 mm2, Mann-Whitney p value=0.04).

Conclusions: Although the sample size is small to draw conclusions and the nature of work is retrospective and descriptive, OCTA has the potential to improve visualisation of ill-defined CNV with dye-based angiography, including occult CNV.

Keywords: Choroid; Imaging; Neovascularisation.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Choroid / blood supply
  • Choroidal Neovascularization / diagnostic imaging*
  • Cross-Sectional Studies
  • Female
  • Fluorescein Angiography*
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tomography, Optical Coherence / methods*