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Retinal Vascular Reactivity as Assessed by Optical Coherence Tomography Angiography

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Published on: March 26, 2020

Subretinal Hyperreflective Material Imaged With Optical Coherence Tomography Angiography.

Kunal K Dansingani¹, Anna C S Tan², Fatimah Gilani³

¹Vitreous Retina Macula Consultants of New York, New York, New York; LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York; Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska; Moorfields Eye Hospital, London, United Kingdom.

American Journal of Ophthalmology

|June 29, 2016

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Summary

Optical coherence tomography angiography (OCTA) can differentiate vascular from avascular subretinal hyperreflective material (SHRM). OCTA artifacts may also help distinguish specific avascular SHRM subtypes in macular diseases.

Area of Science:

Ophthalmology
Medical Imaging
Retinal Diseases

Background:

Subretinal hyperreflective material (SHRM) in macular diseases encompasses various entities like neovascularization, fibrosis, exudation, vitelliform material, and hemorrhage.
Distinguishing SHRM subtypes traditionally requires multiple imaging modalities, hindering prognostic evaluation.

Purpose of the Study:

To investigate the utility of optical coherence tomography angiography (OCTA) in characterizing SHRM.
To identify OCTA flow characteristics and artifacts that can differentiate SHRM subtypes.

Main Methods:

Patients with SHRM from age-related macular degeneration, myopia, pachychoroid disease, and macular dystrophy were included.
OCTA was performed, and images were analyzed for intrinsic flow, retinal projection onto SHRM, projection through SHRM to RPE, and masking of choriocapillaris flow.

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Main Results:

Intrinsic flow was most prominent in type 2 neovascularization and present in residual vessels of fibrosis.
No intrinsic flow was detected in exudation, hemorrhage, or vitelliform lesions.
OCTA effectively distinguished vascular from avascular SHRM components and revealed artifacts that may aid in classifying avascular subtypes.

Conclusions:

OCTA is a valuable tool for differentiating vascular and avascular components within SHRM.
Specific OCTA findings and artifacts can assist in the classification of various SHRM subtypes, potentially improving diagnostic accuracy and prognostic assessment.