Abstract
This study analyze the morphological characteristics of branching vascular networks (BVN) in polypoidal choroidal vasculopathy (PCV) using optical coherence tomography angiography (OCTA), and correlate imaging characteristics with clinical presentations. We presented a retrospective observational case series for fifty cases of PCV confirmed by indocyanine green angiography. Macular OCTA were done by the AngioVue. The PCV cases were classified by distinct morphologic patterns of BVN by two retina specialists and clinical features were analyzed. The sensitivity of polyp detection by OCTA was 86% after manual segmentation and that of BVN was 90%. Three distinct morphologic patterns of BVN were identified. (1) The “Trunk” pattern (47%) exhibited major vessel trunk with features including presence of drusens, thin choroid, and larger BVN area. (2) The “Glomeruli” pattern (33%) showed anastomotic vascular network without major trunk. (3) The “Stick” pattern (20%) had localized BVN and the thickest choroid. Subtypes 2 and 3 held higher recurrence rate. In conclusions, the precise visualization of BVN on OCTA supported that OCTA might be a noninvasive tool to study the morphology of BVN in PCV, which exhibits three different morphological types. Identifying the morphology of BVN has the potential to prognosticate outcomes in PCV patients.
Highlights
The presentation of polypoidal choroidal vasculopathy (PCV) varied widely among patients
The vision remained stable and was 0.503 in logarithm of the minimum angle of resolution (LogMAR) for the final best-corrected visual acuity (BCVA) 6-months after photodynamic therapy (PDT). This present study demonstrated the application of optical coherence tomography angiography (OCTA) in the diagnosis and follow-up of PCV cases
We defined three different types of branching vascular networks (BVN) patterns based on the morphological features on OCTA
Summary
The presentation of PCV varied widely among patients. Yuzawa et al classified PCV into two types according to the presence of feeder vessels or not[13]. Tan et al differentiated PCV into 3 subtypes according to the presence of leakage in ICGA14. Freund et al proposed that PCV may develop from long-standing Type 1 choroidal neovascularization, in line with the believe that PCV is a pachychroidal spectrum disease[15]. The possible diversity of PCV presentation remains unclear. The high resolution and detection rate of BVN by OCTA may provide more detailed clues in the presentation and pathogenesis of PCV. The purpose of the present study was to categorize and describe the morphological characteristics of BVN in PCV by OCTA, and correlated the imaging characteristics with the clinical presentations
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