Characteristics of Polypoidal Choroidal Vasculopathy Evaluated by Multispectral Imaging.

Abstract

To analyze the morphological and pathological characteristics of polypoidal choroidal vasculopathy (PCV) on multispectral imaging (MSI). This prospective study included patients with a clinical diagnosis of treatment-naive PCV. All patients underwent a complete ophthalmological examination including fundus photography, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), optical coherence tomography (OCT), and MSI. MSI was obtained by digital multispectral ophthalmoscope, which allows the visualization of retinal and choroidal structures progressively. The characteristics of PCV on MSI were analyzed and compared with ICGA. Sixteen eyes of 14 patients (mean age 60.9 years ± 9.2 years; 11 male and three female) were included for analysis. Polypoidal lesions were detected in 15 eyes (93.8%) by MSI with nodular or nebulous hyperreflectance on choroidal oxy-deoxy map. MSI was able to reveal all the branching vascular networks (BVNs) detected by ICGA. Retinal pigment epithelial atrophy with melanin stacking was found with MSI infrared wavelengths around pigment epithelial detachment (PED) and in areas above the BVNs in 13 eyes (81.3%). The sensitivity and specificity of MSI were 93.8% and 100%, respectively, for identifying typical PCV with both BVN and polypoidal lesions. MSI appears to be a promising modality for detecting noninvasively the vascular and structural changes in PCV, especially for BVN. MSI may also be used to monitor the metabolic and functional changes of retinal pigment epithelium secondary to polypoidal lesions. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:e249-e255.].