In vivo demonstration of the anatomic differences between classic and occult choroidal neovascularization using optical coherence tomography.

Abstract

To determine architectural differences between classic and occult choroidal neovascularization (CNV) in vivo. Prospective observational case series. Twenty-two patients with acute CNV underwent fluorescein angiography and optical coherence tomography (OCT), which were analyzed by separate blinded observers. In 87.5% of angiographically labeled "classic" CNV a discreet subretinal lesion corresponding to the neovascular complex could be seen above and separate to the retinal pigment epithelium on OCT. This was found in only 13.3% of "occult" CNV. With the latest commercially available OCT equipment it is now possible to confirm in vivo the previously proposed anatomic differences between fluorescein angiographically labeled classic and occult CNV. Classic CNV appear to grow predominantly in the subretinal space, whereas the majority of occult lesions do not. Optical coherence tomography features of CNV may correlate with response to photodynamic therapy or angiostatic treatments, as well as predicting the success of surgical removal.