Imaging analysis with optical coherence tomography: relevance for submacular surgery in high myopia and in multifocal choroiditis

Retina. 2002 Apr;22(2):192-201. doi: 10.1097/00006982-200204000-00010.

Abstract

Purpose: To classify the preoperative and postoperative optical coherence tomography (OCT) findings for subfoveal choroidal neovascularization (CNV) related to high myopia and multifocal choroiditis (MFC) and to correlate these findings with surgical outcome.

Methods: Ten consecutive patients presenting with subfoveal CNV related to either MFC or degenerative myopia were evaluated. Each patient underwent a biomicroscopic examination, fluorescein and indocyanine green angiographies, as well as OCT before and after surgical removal of CNV. Four different parameters were considered in the analysis of all OCT scans: tissue reflectivity, location of the CNV band, presence or absence of a separation zone, and reflectivity underneath the retinal pigment epithelium (RPE) band.

Results: For all six eyes with MFC, OCT showed a hyperreflective band anterior to the RPE with a separation zone and an optically clear zone underneath the RPE. Visual acuity improved in all six eyes. For the degenerative myopia group (4 eyes), OCT revealed findings similar to those observed for MFC for 1 eye, which had a favorable postoperative outcome. The remaining three myopic eyes with different OCT patterns had poor postoperative outcomes.

Conclusion: Optical coherence tomography can provide preoperative clues for submacular surgery. Eyes with CNV located anterior to and separated from the RPE that have an "optically clear zone" underneath are the best candidates for surgical removal. Such a feature was correlated with a good postoperative outcome.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Choroidal Neovascularization / diagnosis*
  • Choroidal Neovascularization / etiology
  • Choroidal Neovascularization / surgery
  • Choroiditis / complications*
  • Coloring Agents
  • Diagnostic Techniques, Ophthalmological*
  • Female
  • Fluorescein Angiography
  • Humans
  • Indocyanine Green
  • Interferometry
  • Light
  • Macula Lutea / surgery*
  • Male
  • Middle Aged
  • Myopia / complications*
  • Postoperative Period
  • Prospective Studies
  • Tomography
  • Visual Acuity

Substances

  • Coloring Agents
  • Indocyanine Green