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OCT Angiographic Findings in Retinal Angiomatous Proliferation.

Felix Heine1, Jona F Schick1, Gabriele E Lang1

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Optical coherence tomography angiography (OCT-A) accurately diagnoses retinal angiomatous proliferation (RAP) stage 1 non-invasively. This method offers depth-selective imaging, surpassing traditional fluorescein angiography for RAP lesion localization.

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Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Retinal Diseases

Background:

  • Optical coherence tomography angiography (OCT-A) enables non-invasive visualization of retinal and choroidal blood flow.
  • Unlike fluorescein angiography (FA), OCT-A does not require dye injection and provides depth-selective imaging.
  • OCT-A and FA were compared in patients with neovascular age-related macular degeneration (AMD) presenting with retinal angiomatous proliferation (RAP) stage 1, characterized by intraretinal neovascularizations.

Purpose of the Study:

  • To compare the diagnostic capabilities of OCT-A and FA in patients with neovascular AMD and RAP stage 1.
  • To evaluate the depth-selective information provided by OCT-A for localizing RAP lesions.
  • To assess the non-invasive advantages of OCT-A over FA.

Main Methods:

  • Three patients with neovascular AMD and RAP stage 1 underwent examination using OCT, OCT-A, and FA.
  • A qualitative analysis compared OCT-A en-face images and FA leakage, with depth-selective assignment using OCT-A B-scans.
  • Imaging included ZEISS CIRRUS HD-OCT 5000, ZEISS AngioPlex OCT-Angiography, and HRA2 FA between January 2016 and March 2019.

Main Results:

  • Diagnosis of RAP stage 1 was confirmed by OCT, FA, and OCT-A in all three patients (ages 66-89).
  • OCT-A visualized intraretinal blood flow in the RAP lesions, with lesions localized to superficial and/or deep vascular plexuses.
  • FA identified RAP lesions, but OCT-A provided superior depth-selective localization, identifying more lesions in one patient.

Conclusions:

  • OCT-A is highly suitable for diagnosing RAP stage 1, offering comparable clarity to FA.
  • The non-invasive nature and depth-selective capability of OCT-A are significant advantages over FA.
  • OCT-A successfully assigned RAP stage 1 lesions to either the superficial or deep vascular plexus, information not achievable with FA's summary image.