Polypoidal Choroidal Vasculopathy on Swept-Source Optical Coherence Tomography Angiography with Variable Interscan...

Area of Science:

• Ophthalmology
• Medical Imaging
• Vascular Biology

Background:

• Polypoidal choroidal vasculopathy (PCV) is a significant cause of vision loss.
• Understanding blood flow dynamics in PCV lesions is crucial for diagnosis and treatment.
• Current imaging techniques may have limitations in assessing flow within PCV polyps.

Purpose of the Study:

• To evaluate relative blood flow speeds in PCV using a novel optical coherence tomography angiography (OCTA) algorithm called variable interscan time analysis (VISTA).
• To characterize blood flow within the branching vascular network (BVN) and polyps of PCV lesions.

Main Methods:

• Prospective cross-sectional study of patients with confirmed PCV.
• Retinal and choroidal OCTA performed using a swept-source OCT system.
• VISTA-OCTA applied to analyze blood flow speeds in BVN and polyps.

Main Results:

• VISTA-OCTA visualized BVN and polyps in most PCV lesions.
• Heterogeneous blood flow speeds were observed within polyps, with faster flow at the periphery and slower flow centrally.
• Branching vascular networks showed slower flow compared to retinal vessels, with faster flow in larger vessels.

Conclusions:

• VISTA-OCTA demonstrates variable blood flow speeds within PCV polyps, potentially indicating turbulent flow.
• Slow flow within polyps may explain limitations of standard OCTA in detecting all PCV lesions.
• Findings provide insights into PCV pathogenesis and can inform clinical diagnosis and management.