Fluorescein angiography and optical coherence tomography concordance for choroidal neovascularisation in multifocal choroidtis

Abstract

Purpose: To compare the utility of fluorescein angiography (FA) and optical coherence tomography (OCT) as diagnostic adjuncts in evaluating symptomatic patients with choroidal neovascularisation (CNV) due to multifocal choroiditis (MFC).

Methods: Patients with CNV due to MFC were retrospectively evaluated in a consecutive fashion. Fundus photography, FA, OCT and biomicroscopy were used to establish the diagnosis. Primary outcome measures included CNV classification (type 1 or occult and type 2 or classic) location and the associated FA and OCT findings.

Results: Twenty eyes from 17 patients were included in the study. In 19 eyes (95%) the FA revealed CNV type 2; in one eye (5%) the type of CNV was indeterminate due to a subretinal haemorrhage that covered the lesion. Thirteen eyes had OCT imaging and all revealed hyper-reflectance beneath the neurosensory retina. However, only 53.8% revealed subretinal fluid (SRF) or intraretinal cystic abnormalities.

Conclusions: The CNV in MFC is virtually always type 2, or so-called classic CNV, with vessels beneath the neurosensory retina. Except when blocked by subretinal blood, the neovascularisation is clearly demonstrated by FA. In contrast, only 53.8% of these eyes showed clear evidence of actively proliferating neovascularisation on OCT. Therefore, eyes suspected of having CNV in MFC should be evaluated with FA.