Inflammatory choroidal neovascularization imaged by optical coherence tomography - angiography

Purpose To describe the optical coherence tomography - angiography (OCT- A) findings in patients with uveitis related neovascularization. Methods We 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. Results Six 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. Conclusions OCT-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.