Guoji Yanke Zazhi (Feb 2020)
Diagnostic value of optical coherence tomography angiography in choroidal rupture
Abstract
AIM: To investigate the diagnostic value of optical coherence tomography angiography(OCTA)in choroidal rupture and evaluate the imaging features. METHODS: We selected 25 patients(25 eyes)whom were diagnosed as choroidal rupturein in this retrospective observational case. All patients underwent fundus photography, fundus fluorescein angiography(FFA), indocyannine green angiograph(ICGA), spectral domain optical coherence tomography(SD-OCT)and OCTA examinations.RESULTS: All the patients showed the lesions were mostly located in the macular area or on the temporal side of the optic disc, with a yellow-white arc hyperreflexia with stripes shape, it can be accompanied by retinal choroidal edema and subretinal hemorrhage. In the early stage of FFA, it showed a curved shape window defect of choroidal rupture, and fluorescent staining in the late stage. When secondary to choroidal neovascularization(CNV), the active CNV showed a hyperfluorescence leakage. SD-OCT showed the reflex of outer retina and choroidal capillary layer were ruptured, the reflex of the surrounding tissue were reinforced, the subretinal small cluster hyperreflexia can be seen. The granulation tissue showed an arc hyperreflexia with “stripe shape” in the outer retinal and choroid capillary layer of OCTA angiogram image. On the B-scan, it showed an inwardly bulge or outwardly recess shap, with blood flow signal inside. When secondary to CNV, vascular morphology can be seen clearly, most of them were cluster shape, which is different from the granulation tissue.CONCLUSION: Although the granulation tissue and CNV of choroid rupture showed cluster shap and blood flow signal on OCTA, there were significant differences in morphology and tissue composition between them. Through the display of OCTA stratification and the detailed observation of the lesion, the diagnosis rate of secondary CNV in choroidal rupture can be improved.
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