IMPROVED VISUALIZATION OF POLYPOIDAL CHOROIDAL VASCULOPATHY LESIONS USING SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY

Purpose: To report the tomographic features of vascular lesions beneath the retinal pigment epithelium in eyes with polypoidal choroidal vasculopathy by using spectral-domain optical coherence tomography (SD-OCT). Design: Retrospective observational case series. Methods: Angiograms and images obtained using the prototype SD-OCT system were compared for 21 eyes of 21 patients with polypoidal choroidal vasculopathy to identify sub-retinal pigment epithelium abnormalities visible on three-dimensional and enhanced SD-OCT images. Results: On angiography, a branching vascular network and at least 1 polypoidal lesion were visible in all 21 eyes; 10 eyes also had pigment epithelial detachment (PED). SD-OCT revealed a thin straight line of high reflectivity-Bruch's membrane-associated with the branching vascular network in all 21 eyes, polypoidal lesions, 19 (90%) of the 21 eyes; and PED, 9 (90%) of the 10 eyes with PED. The vascular abnormalities of polypoidal choroidal vasculopathy (polypoidal lesion and branching vascular network) identified with angiograms were visualized on SD-OCT images in 20 of the 21 eyes (95%) as areas of moderate reflectivity between the clearly delineated abnormal section of retinal pigment epithelium and Bruch's membrane. Conclusions: Enhanced SD-OCT imaging clearly depicted Bruch's membrane beneath areas of abnormal retinal pigment epithelium in the same locations where the vascular abnormalities of polypoidal choroidal vasculopathy were evident on angiography.