Inflammatory choroidal neovascularization imaged by optical coherence tomography – angiography

Abstract

PurposeTo describe the optical coherence tomography ‐ angiography (OCT‐ A) findings in patients with uveitis related neovascularization.MethodsWe included all patients diagnosed with inflammatory neovascularization (CNV) at the Pitie Salpetriere hospital between 2016/09/01 and 2016/11/15. All patients were assessed including best corrected visual acuity, clinical inflammatory parameters, multimodality imaging, fluorescein angiography, ICG and SD‐OCT or SS‐OCT. All patients underwent OCT angiography with SS‐OCT DRI Triton (Topcon, Japan) or/and Spectralis Angiography OCT (HRA, Heidelberg, Germany). OCT‐A images were analyzed and compared with en face and B‐OCT.ResultsSix patients (7 eyes), 3 women and 3 men, with a mean age of 55 years, were included. Three patients were diagnosed with ocular sarcoidosis and the rest of the patients with Birdshot chorioretinopathy, HSV‐2 uveitis and ocular tuberculosis. OCT‐A revealed inflammatory pre retinal pigment epithelial CNV in all cases. Three lesions were localized in the papillo‐macular region and four close to the vascular arcades. The main length of the major axis was 2.806 microns. All lesions presented a sea fan pattern with an anastomotic network and a thin capillaries network surrounded by a dark halo. They were attached to a single or to multiple thick branches. Two patients had a follow‐up of one month after the anti‐VEGF therapy confirming the rapid fibrosis of these vessels. The characteristics of inflammatory CNV seem to differ from those of CNV in neovascular age related macular degeneration scanned with OCT‐A. The branching seems to be less important, and capillaries thinner and pedicles thicker.ConclusionsOCT‐A is a new complementary imaging method for the diagnosis of inflammatory CNV. The features and the evolution of these lesions need to be investigated in further studies.