Spectral domain-optical coherence tomography retinal biomarkers in choroidal neovascularization of multifocal choroiditis, myopic choroidal neovascularization, and idiopathic choroidal neovascularization

Abstract

Objective: To use optical coherence tomography (OCT) to compare retinal biomarkers of choroidal neovascularization (CNV) secondary to multifocal choroiditis (MFC), myopic choroidal neovascularization (mCNV), and idiopathic choroidal neovascularization (ICNV) and to provide a basis for its clinical diagnosis and treatment. Methods: In this retrospective case study, patients admitted to the Second Hospital of Hebei Medical University between January 2018 and January 2021 who were initially diagnosed with CNV secondary to MFC, mCNV, and ICNV were categorized into groups, by disease, for analysis. Spectral domain-OCT (SD-OCT) was used to describe and measure the morphological characteristics of CNV lesions in each group. The retinal biomarkers of CNV in MFC, mCNV, and ICNV were compared. Results: Sixty-eight patients (71 eyes) were included and all eyes were diagnosed with active type 2 CNV. The MFC group had higher refraction than the ICNV group (P2 < 0.05). The choroidal thickness (CT) and CNV diameter of the MFC group were significantly greater than those of the mCNV group (P1 < 0.05). The number of eyes with sub-retinal fluids (SRF) and a "pitchfork sign" was significantly greater in the MFC group than in the mCNV group (P1 < 0.05). There was a significant difference only in CT) values between the MFC and ICNV groups (P2 < 0.001), but not in the other observation indicators (P2 > 0.05). Conclusions: OCT biomarkers, such as the diameter of the CNV, SRF, the "pitchfork sign," and CT under CNV are useful in distinguishing CNV secondary to MFC from mCNV, which can allow the timely selection of treatment in some difficult cases. There were no differences between the MFC group and ICNV group except in refractive error, which indicates that some ICNV cases may be an early stage of a type of occult chorioretinitis. Long-term follow-up is needed for ICNV patients to confirm whether there is any potential inflammation. KEY MESSAGESSometimes, it is difficult to separate MFC with CNV from myopic CNV and ICNV in clinical. OCT biomarkers, such as the diameter of the CNV, SRF, the "pitchfork sign," and CT under CNV are useful in distinguishing CNV secondary to MFC from mCNV. There were no differences between the MFC group and ICNV group except in refractive error.

A versatile laser-induced porcine model of outer retinal and choroidal degeneration for preclinical testing

“…OCTA visualizes vasculature by detecting motion contrast of moving blood cells and can even evaluate subclinical alterations in CC ( 29 , 30 ). Figure 3, A–C , shows a comparison between ICGA imaging ( Figure 3, A and B ) and CC segmented OCTA ( Figure 3C ) of the same retinal region, revealing higher resolution of OCTA.…”

Pitchfork sign following pars Plana vitrectomy for idiopathic epiretinal membrane: A case report

“…1 Gao et al confirmed this pathogenetic relationship, showing that pitchfork sign was present in 40% of patients with MFC. 12 Over time, De Mello et al first reported in 2015, 13 followed by Rajabian et al in 2019, 2 demonstrated the presence of the pitchfork sign associated with choroidal osteoma. In these patients, focal choroidal excavation developed at the level of the ossifying tumor, resulting in CNV with associated hyperreflective finger-like projections.…”

“…Gao et al confirmed this pathogenetic relationship, showing that pitchfork sign was present in 40% of patients with MFC. 12…”

Choroidal Morphologic and Vascular Features in Patients With Myopic Choroidal Neovascularization and Different Levels of Myopia Based on Image Binarization of Optical Coherence Tomography

“…Anatomic studies demonstrate that choroid plays a crucial role in supporting photoreceptor function; such atrophy may have significant deleterious impact on outer retina and RPE health. Previous studies have put forth the theory that alterations in the choroidal blood perfusion may lead to degenerative changes in pathological myopia and high myopia ( 2 ). Narrowing and loss of large choroidal vessels, and occlusion of choriocapillaris, have been suggested to be important in the pathogenesis of chorioretinal atrophy in pathological myopia ( 25 ).…”

“…Myopia is one of the most common ocular disease globally, with a prevalence of 10-30% in the adult population and 80-90% in young adults in East and Southeast Asia (1). Pathological myopia is one of the leading causes of visual impairment in the world, in which excessive axial elongation of the globe causes biomechanical stretching and thinning of choroid and retinal pigmented epithelium (RPE) layers (2)(3)(4), leading to increased risk of chorioretinal complications such as myopic choroidal neovascularization (mCNV), posterior staphyloma, lacquer cracks, and myopic foveoschisis, among which mCNV is considered to be sight-threatening with poor prognosis without treatment (5)(6)(7)(8)(9)(10).…”