Optical Coherence Tomography Angiography Study of Choroidal Neovascularization Associated With Early-Onset Drusen

Abstract

Purpose: To report three middle-aged cases with choroidal neovascularization (CNV) associated with early-onset drusen documented with optical coherence tomography angiography (OCTA).Methods: Three patients with bilateral early-onset drusen were referred to our hospital. Fundus examination, fluorescein angiography, indocyanine green angiography, OCTA, and other multimodal imaging were performed.Results: Case 1 involved a 47-year-old woman who presented with sudden unilateral anorthopia. She had no previous systemic pathologies. Funduscopic examination and fluorescein angiography revealed bilateral large colloid drusen accompanied by unilateral mild subretinal hemorrhage. Indocyanine green angiography revealed CNV, although it was unclear in fluorescein angiography. Optical coherence tomography angiography also showed interconnecting CNV beneath the retinal pigment epithelium. Case 2 involved a 40-year-old woman with membranoproliferative glomerulonephritis Type 3 who presented with unilateral anorthopia. On fluorescein angiography, cuticular drusen secondary to membranoproliferative glomerulonephritis were seen in both eyes. An interconnecting vascular network was revealed with OCTA and indocyanine green angiography indicating Type 1 CNV in the affected eye. Case 3 involved a 47-year-old man without any medical or family history. Predominant large colloid drusen associated with cuticular drusen were seen in both eyes. Unilateral mild serosanguinous changes were accompanied in the macula, where Type 1 CNV was detected with OCTA.Conclusion: All our cases with early-onset drusen showed Type 1 CNV that was detected by indocyanine green angiography or OCTA. Optical coherence tomography angiography has a potential to help noninvasively diagnose CNV in the cases of EOD.

Clear subretinal fluid in a case of non-neovascular early-onset drusen: Swept-source imaging evaluation

“…In such cases, one may suspect an underlying active MNV resulting in accumulation of subretinal fluid. 3,15,16 It is imperative to note that early-onset drusen may have small MNVs which may be difficult to detect on routine imaging. In our case, presence of MNV was ruled out by checking the segmentation slabs, and analyzing OCTA en face images of outer retina/choriocapillaris.…”

Cuticular drusen presenting with central serous chorioretinopathy in both eyes: A case report

“…Although no epidemiological studies have investigated the prevalence of cuticular drusen using multimodal imaging, they predominantly occur in Caucasians, and reports on cuticular drusen in Asians are limited. [7–9] Apart from the characteristics mentioned above, cuticular drusen possess unique characteristics, including early onset and an increased risk of acquired vitelliform lesions in addition to MNV and GA. [10,11]…”

“…Although no epidemiological studies have investigated the prevalence of cuticular drusen using multimodal imaging, they predominantly occur in Caucasians, and reports on cuticular drusen in Asians are limited. [7][8][9] Apart from the characteristics mentioned above, cuticular drusen possess unique characteristics, including early onset and an increased risk of acquired vitelliform lesions in addition to MNV and GA. [10,11] However, no reports have documented macular complications in eyes with cuticular drusen other than the 3 abovementioned entities. In this report, we describe a case of cuticular drusen with central serous chorioretinopathy (CSC) in both eyes.…”