Guoji Yanke Zazhi (Nov 2022)
Comparative analysis of the characteristics of choroidal neovascularization and polypoidal choroidal vasculopathy in optical coherence tomography angiography and indocyanine green angiography images
Abstract
AIM: To compare and observe the characteristics of choroidal neovascularization(CNV)and polypoidal choroidal vasculopathy(PCV)in indocyanine green angiography(ICGA)and optical coherence tomography angiography(OCTA),and to discuss their differences and pros and cons.METHOD: The imaging data of 26 CNV patients(34 eyes)and 19 PCV patients(19 eyes)diagnosed at Hebei Eye Hospital from September 2018 to April 2020 were retrospectively analyzed. There were 20 cases(28 eyes)of wet age-related macular degeneration(w-ARMD)in CNV patients and 6 cases(6 eyes)of chronic central serous chorioretinopathy(CCSC)secondary to CNV. All patients underwent OCTA, fundus fluorescein angiography(FFA)+ICGA, analyzing the characteristic changes of lesions.RESULT: OCTA examination of w-ARMD patients(28 eyes)showed that, except for 2 eyes where no obvious abnormality was seen due to severe bleeding, the morphology of CNV can be seen in the remaining 26 eyes in a clear, three-dimensional way, and even the anatomical level where CNV was located could be found. Among them, 11 eyes examined by OCTA can not only show the morphology, size and affected area of CNV, but also can better distinguish the nourishing vessels, new vessels and anastomotic branches. CNV morphology not detected by FFA+ICGA was found by OCTA in 6 eyes of patients with CCSC secondary to CNV. A clearer vision of abnormal choroidal branching vascular network(BVN)can be found clearer by OCTA than ICGA in 19 eyes of PCV patients, but OCTA cannot show the number of terminal saccular dilatations(polyps)as clearly as ICGA.CONCLUSION: The positive rate of CNV detected by OCTA is higher than that of ICGA. The lesions range of CNV and PCV detected by OCTA is clearer and more stereoscopic than that of ICGA.But it cannot show all terminal saccular dilatations in PCV patients, and it cannot be used to monitor the leakage of CNV or PCV and lesion progression. So it is less effective than FFA+ICGA in this aspect. As a non-invasive examination, OCTA can be used in the follow-up to observe the changes in lesions before and after CNV or PCV treatment.
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