OPTICAL COHERENCE TOMOGRAPHIC CHARACTERISTICS OF IDIOPATHIC CHOROIDAL NEOVASCULARISATION AND STAGING

Authors

  • Syed Nasir Ali Shah Xian Jiaotong University
  • Qian Yan Kang Xian Jiaotong University
  • Bo Ma Xian Jiaotong University
  • Shan Gao
  • Umer Farooq Department of Community Medicine, Ayub Medical College, Abbottabad

Abstract

Background: Idiopathic choroidal neovascularisation (ICNV) is the development of choroidal neovascularisation (CNV) in young adults without any apparent manifestations of primary ocular or systemic diseases We aim to assess characteristics and pathological changes at various stages in ICNV by optical coherence tomography(OCT). Methods: We reviewed clinical charts of 40 ICNV eyes and classified them into three stages. Active stage <1 month, intermediate 1–3 months and cicatricial >3 months period after initiation of treatment in naïve ICNV eyes. OCT characteristics of these morphological changes were determined. Parameters such as mean volume (MV), central macular thickness (CMT) and neovessels size (thickness and diameter) were analyzed and compared using one -way ANOVA. Results: We have 12 males and 28 females with a mean age of 30.1±7.80 years. In active stage, heterogenous activity of CNV was observed, along with disrupted RPE layer, surrounded by subretinal fluids and loss of foveal depression. In intermediate stage, CNV reflection appears homogenous with smooth peripheral Retinal pigment epithelium (RPE) lesion and reduction in retinal thickness. In cicatricial stage, OCT presents dome shaped elevation, strong homogenous reflection, absence of subretinal fluids and reformation of foveal depression. We have found that difference in mean volume and choroidal neovessels thickness was statistically significant in the three stages. Conclusions: In our study we have concluded that OCT is useful tool for following the clinical course of ICNV and understanding the pathological changes in CNV regression. 

References

Ho AC, Yannuzzi LA, Pisicano K, DeRosa J. The natural history of idiopathic subfoveal choroidal neovascularization. Ophthalmology 1995;102(5):782–9.

Cohen SY, Laroche A, Leguen Y, Soubrane G, Coscas GJ. Etiology of choroidal neovascularisation in young patients. Ophthalmology 1996;103(8):1241–4.

Gass JD. Biomicroscopic and histopathologic considerations regarding the feasibility of surgical excision of subfoveal noevascular membranes. Am J Ophthalmol 1994;118(3):285–98.

Derosa JT, Yannuzzi LA, Marmor M, Fotino M, Sorenson JA, Spaide RF. Risk factors for neovascularization in young patients: a case-control study. Doc Ophthalmol 1995;91(3):207–22.

Smith RE, Ganley JP. An epidemiologic study of presumed ocular histoplasmosis. Trans Am Acad Ophthalmol Otolaryngol 1971;75(1):994–1005.

Dreyer RF, Gass DM. Multifocal choroiditis and panuveitis. A syndrome that mimics ocular histoplasmosis. Arch Ophthalmol 1984;102(5):1776–84.

Morgan CM, Sc1hatz H. Recurrent multifocal choroiditis. Ophthalmology 1986;93(8):1138–47.

Lindblom B, Andersson T. The prognosis of idiopathic choroidal. neovascularization in persons younger than 50 years of age. Ophthalmology 1998;105(10):1816–20.

Ghazi NG, Jabbour NM, De La Cruz ZC, Green WR. Clinicopathologic studies of age-related macular degeneration with classic subfoveal choroidal neovascularization treated with photodynamic therapy. Retina 2001;21(5):478–86.

Iida T, Hagimura N, Sato T, Kishi S. Optical coherence tomographic features of idiopathic submacular choroidal neovascularization. Am J Ophthalmol 2000;130(6):763–8.

Byun YJ, Lee SJ, Koh HJ. Predictors of response after intravitreal bevacizumab injection for neovascular age-related macular degeneration. Jpn J Ophthalmol 2010;54(6):571–7.

Shin HJ, Chung H, Kim HC. Correlation of foveal microstructural with vision after anti-vascular endothelial growth factor therapy in age-related macular degeneration. Retina 2013;33(5):964–70.

Framme C, Panagakis G, Birngruber R. Effects on choroidal neovascularization after anti-VEGF Upload using intravitreal ranibizumab, as determined by spectral domain-optical coherence tomography. Invest Ophthalmol Vis Sci 2010;51(3):1671–6.

Fukuchi T, Takahashi K, Uyama M, Matsumura M. Comparative study of experimental choroidal neovascularization by optical coherence tomography and histopathology. Jpn J Ophthalmol 2001;45(3):252–8.

Huang D, Swanson EA, Lin CP, Schuman JS, Stinson WG, Chang W et al. Optical coherence tomography. Science 1991;254(5035):1178–81.

Hee MR, Izatt JA, Swanson EA, Huang D, Schuman JS, Lin C, et al. Optical coherence tomography of the human retina. Arch Ophthalmol 1995;113(3):325–32.

Yannuzzi LA, Hope-Ross M, Slakter JS, Guyer DR, Sorenson JA, Ho AC, et al. Analysis of vascularized pigment epithelial detachments using indocyanine green videoangiography. Retina 1994;14(2):99–113.

Puliafito CA, Hee MR, Lin CP, Reichel E, Schuman JS, Duker JS, et al. Imaging of macular diseases with optical coherence tomography. Ophthalmology 1995;102(2):217–29.

Bloch SB. Implementation studies of ranibizumab for neovascular age-related macular degeneration. Acta Ophthalmol 2013;91:1–22.

Fukuchi T, Takahashi K, Shou K, Matsumura M. Optical coherence tomography (OCT) findings in normal retina and laser-induced choroidal neovascularization in rats. Graefes Arch Clin Exp Ophthalmol 2001;239(1):41–6.

Toju R, Iida T, Sekiryu T, Saito M, Muruko I, Kano M. Near-Infrared Autofluorescence in patients with idiopathic submacular choroidal neovascularization. Am J Ophthalmol 2012;153(2):314–9.

Punjabi OS, Huang J, Rodriguez L, Lyon AT, Jumpol LM, Mirza RG. Imaging characteristics of neovascular pigment epithelial detachments and their response to anti-vascular endothelial growth factor therapy. Br J Ophthalmol 2013;97(8):1024–31.

Shah SNA, Kang QY, Fan XJ, Shahbaz F. Microstructural effects of intravitreal bevacizumab in idiopathic choroidal neovascularisation. J Ayub Med Coll Abbottabad 2015;27(2):259–63.

Shah SNA, Kang QY, Fan XJ, Shahbaz F. Correlation between visual acuity and microstructural changes after intravitreal bevacizumab therapy in naive Idiopathic choroidal neovascularization. Adv Ophthalmol Vis Syst 2015;2(5):00060.

Downloads

Published

2015-12-15

Most read articles by the same author(s)

<< < 1 2 3 > >>