Optical Coherence Tomography Angiography to Distinguish Choroidal Neovascularization From Macular Inflammatory Lesions in Multifocal Choroiditis

Abstract

The combined findings of conventional imaging and OCTA demonstrate distinctive features of inflammatory lesions and CNV in multifocal choroiditis, allowing an appropriate management of these sight-threatening lesions. However, OCTA alone did not distinguish between active and inactive CNVs and should be integrated into an MMI approach.

Optical coherence tomography angiography in comparison with other multimodal imaging techniques in punctate inner choroidopathy

“…A recently published study by Astroz et al looked only for subretinal or intraretinal fluid on FA and OCT in patients with MFC, prior to OCTA analysis. The authors did not observe a statistically significant difference in terms of morphological features such as collaterals, peripheral arcades and dark halo between active and inactive CNVs on OCTA 12. Similar to our results, Zahid et al reported that sub-RPE lesions did not reveal neovascular flow on OCTA.…”

Optical coherence tomography and optical coherence tomography angiography in uveitis: A review

“…However, dye leakage can occur from both iCVNs and non‐neovascular inflammatory foci (Figure A‐C). OCTA can clearly demonstrate the presence of the neovascular network forming the iCNV (Figure D), a feature that is not present in other types of lesions …”

“…In most OCTA scans, iCNV appears as a well‐circumscribed neovascular network, typically located at the level of the avascular zone (outer retina RPE) . Due to alterations in the normal anatomy of the retinal layers induced by the exudative process, the use of automated segmentation software can fail .…”

“…OCTA can clearly demonstrate the presence of the neovascular network forming the iCNV ( Figure 11D), a feature that is not present in other types of lesions. 71 The majority of iCNVs are located above the RPE in the subretinal space, similar to the so-called type 2 or classic lesions of exudative age-related macular degeneration. 70 On structural OCT scans, an iCNV appears as an accumulation of hyper-reflective material seated between the disrupted RPE and the outer retinal layers, rarely accompanied by a sub-RPE component ( Figure 12A).…”

“…In most OCTA scans, iCNV appears as a wellcircumscribed neovascular network, typically located at the level of the avascular zone (outer retina RPE). 58,69,71 Due to alterations in the normal anatomy of the retinal layers induced by the exudative process, the use of automated segmentation software can fail. 74 Manual adjustments of the reference segmentation line and plane are often necessary to accurately define the neovascular network and differentiate it from superficial retinal vessels and underlying choroidal structures.…”