OCT Angiography of Treatment-Naïve Quiescent Choroidal Neovascularization in Pachychoroid Neovasculopathy

Purpose To estimate the prevalence of treatment-naïve quiescent choroidal neovascularization (CNV) among eyes with pachychoroid neovasculopathy and to investigate the OCT angiography (OCT-A) features. Design Prospective case series. Participants From a pool of 55 eyes of 54 patients (mean age, 52±10.2 years; 35 male/19 female) with pachychoroid neovasculopathy, we identified 49 eyes of 49 patients previously treated for actively leaking CNV, whereas 6 eyes of 6 patients met the selection criteria for treatment-naïve quiescent CNV. Methods Treatment-naïve quiescent CNV was identified in a pool of patients with pachychoroid neovasculopathy consecutively presenting between January 2016 and June 2016 at 2 high-volume referral centers. Each enrolled patient underwent a complete ophthalmologic examination that included fluorescein angiography, indocyanine green angiography (ICGA), and OCT-A with the AngioPlex CIRRUS HD-OCT Model 5000 (Carl Zeiss Meditec, Inc, Dublin, CA) or the AngioVue RTVue XR Avanti (Optovue, Freemont, CA). Main Outcome Measures Prevalence and OCT-A features of treatment-naïve quiescent CNV. Results We estimate a prevalence of 10.9% (2.7–19.1, 95% confidence intervals) for treatment-naïve quiescent CNV among eyes with pachychoroid neovasculopathy. Type 1 quiescent neovascular networks were clearly visible in all 6 eyes by OCT-A, and there was agreement of 100% between the readers in the correspondence between ICGA and OCT-A images and in the rating of OCT-A imaging features of CNV. The most frequently observed features (well-defined margin and irregular shape) were seen in 4 of 6 eyes. Conclusions Using OCT-A allows the clinician to noninvasively identify treatment-naive quiescent CNV and may be considered as a useful tool in guiding the frequency of follow-up examinations and treatment decisions in pachychoroid disease.