Diagnostic Evaluation of Type 2 (Classic) Choroidal Neovascularization: Optical Coherence Tomography, Indocyanine Green Angiography, and Fluorescein Angiography

Sulzbacher, Florian; Kiss, Christopher; Munk, Marion R.; Deák, Gábor; Sacu, Stefan; Schmidt‐Erfurth, Ursula

doi:10.1016/j.ajo.2011.04.011

Cited by 53 publications

(30 citation statements)

References 19 publications

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“…The criteria used for the detection of CNV with SD-OCT primarily involved assessing retinal changes that occurred secondary to a breakdown in the outer blood-retinal barrier such as the presence of subretinal fluid, a 10% increase in retinal thickening or intraretinal cystic abnormalities. 15 Other studies like ours and that by Sandhu et al 13 have graded OCT images for the morphological features of the fibrovascular complex 19,23 in addition to their exudative consequences of retinal thickening and oedema as opposed to just the latter. In 5% of eyes in our study no SRF or IRF was present on SD-OCT, yet FFA demonstrated an occult lesion.…”

Section: Eyementioning

confidence: 99%

The diagnostic accuracy of spectral-domain optical coherence tomography for neovascular age-related macular degeneration: a comparison with fundus fluorescein angiography

Wilde

Patel²,

Lakshmanan

et al. 2015

Eye

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Section: Eyementioning

confidence: 99%

The diagnostic accuracy of spectral-domain optical coherence tomography for neovascular age-related macular degeneration: a comparison with fundus fluorescein angiography

Wilde

Patel²,

Lakshmanan

et al. 2015

Eye

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“…The traditional multimodal imaging, based on fluorescein angiography (FA), indocyanine green angiography (ICGA), and spectral-domain optical coherence tomography (OCT), leads to a better understanding of the pathophysiologic features of retinal and choroidal diseases [1]. It allows obtaining information about the normal retinal and choroidal anatomy, nearly comparable to histological findings.…”

Section: Introductionmentioning

confidence: 99%

Optical Coherence Tomography Angiography in Healthy Subjects and Diabetic Patients

et al. 2017

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Fluorescein angiography and indocyanine green angiography provide information about the normal retinal and choroidal vascular perfusion. They allow the evaluation of different diseases and increase the capability to define and diagnose several pathological conditions. Fluorescein angio graphy is the “gold standard” in imaging the retinal vascular bed and its changes, although not all the different layers of the capillary network can be visualized in a bidimensional examination. Optical coherence tomography angiography allows a depth-resolved visualization of the retinal and choroidal microvasculature, by calculating the difference (decorrelation) between static and nonstatic tissue. Given that the main moving elements in the eye fundus are contained in vessels, determining a vascular decorrelation signal permits a three-dimensional visualization of the retinal and choroidal vascular network without the administration of an intravenous dye. Moreover, a complete morphofunctional assessment may help in defining both the origin and the clinical activity of different vascular diseases such as diabetic retinopathy.

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“…Fluorescein angiography (FA) is currently the method of choice for diagnosing and classifying CNV as of the classic, occult, or combination subtype, while indocyanine green angiography (ICGA) can be used to identify the entire extension of the CNV lesion because of its ability to image sub-RPE components of CNV [5]. Spectral-domain optical coherence tomography (SD-OCT) has revolutionized the diagnostic approach to AMD because it enables definition of the morphological features of the fibrovascular complex as well as the exudative consequences of fluid accumulation with retinal thickening and edema [6].…”

Section: Introductionmentioning

confidence: 99%

Optical Coherence Tomography Angiography during Follow-Up: Qualitative and Quantitative Analysis of Mixed Type I and II Choroidal Neovascularization after Vascular Endothelial Growth Factor Trap Therapy

et al. 2015

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Purpose: To report the optical coherence tomography angiography (OCT-A) findings in an exudative age-related macular degeneration (AMD) patient presenting mixed type I and II choroidal neovascularization (CNV) during follow-up after intravitreal vascular endothelial growth factor (VEGF) trap treatment. Methods: The clinical assessment included both traditional multimodal imaging, based on fluorescein angiography (FA), indocyanine green angiography (ICGA) and B-scan OCT, and OCT-A at baseline and follow-up. OCT-A images were obtained using a Spectralis OCT-A prototype able to acquire 70,000 A-scans per second, with a resolution of 7 µm axially and 14 µm laterally. An amplitude decorrelation algorithm developed by Heidelberg Engineering was applied to a volume scan, on a 15 × 5° area, which was composed of 131 B-scans (35 frames per scan) at a distance of 11 µm each. The borders of type I and type II CNV were manually outlined and then the areas were analyzed using the provided automated software before and after treatment. Results: The qualitative approach revealed a substantial decrease in the visibility of tiny branching vessels and anastomoses both in type I and type II components of the neovascular complex, associated with persistence of a clear hyperintense signal coming from the larger trunks, which remained well-perfused. Quantitative analysis confirmed a reduction of the lesion area after VEGF trap treatment: the type II component decreased from 0.25 to 0.19 mm², while the type I component decreased from 2.03 to 1.80 mm². Conclusions: Our study qualitatively and quantitatively demonstrated the response of a mixed type I-II CNV to intravitreal VEGF trap therapy. Although FA remains the gold standard for determining the presence of leakage and OCT easily shows fluid accumulation and its variations, OCT-A offers noninvasive monitoring of the retinal and choriocapillaris microvasculature in patients with CNV, aiding in diagnosis and treatment decisions during follow-up.

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Diagnostic Evaluation of Type 2 (Classic) Choroidal Neovascularization: Optical Coherence Tomography, Indocyanine Green Angiography, and Fluorescein Angiography

Cited by 53 publications

References 19 publications

The diagnostic accuracy of spectral-domain optical coherence tomography for neovascular age-related macular degeneration: a comparison with fundus fluorescein angiography

The diagnostic accuracy of spectral-domain optical coherence tomography for neovascular age-related macular degeneration: a comparison with fundus fluorescein angiography

Optical Coherence Tomography Angiography in Healthy Subjects and Diabetic Patients

Optical Coherence Tomography Angiography during Follow-Up: Qualitative and Quantitative Analysis of Mixed Type I and II Choroidal Neovascularization after Vascular Endothelial Growth Factor Trap Therapy

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