title: Optical Coherence Tomography Angiography of a Choroidal Neovascularization in Adult Onset Foveomacular Vitelliform Dystrophy: Pearls and Pitfalls.
abstract: OBJECTIVE
  The purpose of this study was to determine the sensitivity and specificity of optical coherence tomography angiography (OCT-A) in detecting choroidal neovascularization (CNV)-complicating adult onset foveomacular vitelliform dystrophy (AOFVD) and to highlight the possible pitfalls related to the heterogeneous spectrum of acquired vitelliform maculopathies.
  
  
  METHODS
  Twenty-five eyes of 22 consecutive AOFVD patients with suspected CNV were enrolled. Conventional multimodal imaging findings, based on fluorescein angiography (FA), indocyanine green angiography (ICGA) and B-Scan OCT, were used as a basis and were compared with those obtained from OCT-A to define its sensitivity and specificity for detecting CNV in the case of AOFVD. A qualitative and quantitative analysis of the CNV appearance and of the associated OCT-A findings were also performed with the aim of defining features and elucidating possible diagnostic pitfalls.
  
  
  RESULTS
  Conventional multimodal imaging allowed diagnosis of a CNV in 5 of 25 eyes (20%), whereas a CNV lesion was clearly observed on OCT-A in 4 of 25 cases (16%). The sensitivity and specificity of CNV detection by OCT-A in cases of AOFVD was 4 of 5 cases (80%) and 20 of 20 cases (100%), respectively. Optical coherence tomography angiography in 10 cases (40%) showed a focal hyperintense signal, without vascular aspects, at the level of the outer nuclear layer or immediately above the subretinal material accumulation.
  
  
  CONCLUSIONS
  Our study demonstrates the capability of OCT-A to allow diagnosis of the presence of a CNV in AOFVD patients. Although FA remains the gold standard for determining the presence of a neovascular network, OCT-A offers noninvasive monitoring of the retinal and choroidal microvasculature, aiding in diagnosis and treatment decisions during follow-up.
authors.affiliation: Centre de l'Odéon, Paris, France 2Department of Biomedical and Surgical Sciences, Section of Ophthalmology, University of Perugia, S. Maria della Misericordia Hospital, Perugia, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Lupidi
authors.affiliation: Centre de l'Odéon, Paris, France 3Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, Université Paris Est, Créteil, France.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Coscas
authors.affiliation: Department of Biomedical and Surgical Sciences, Section of Ophthalmology, University of Perugia, S. Maria della Misericordia Hospital, Perugia, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Cagini
authors.affiliation: Centre de l'Odéon, Paris, France 3Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, Université Paris Est, Créteil, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Coscas
mesh_terms: D000368:Aged; D002829:Choroid / Q000473:pathology*; D020256:Choroidal Neovascularization / Q000175:diagnosis* / Q000473:pathology; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005584:Fovea Centralis / Q000473:pathology*; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D057826:Vitelliform Macular Dystrophy / Q000175:diagnosis* / Q000473:pathology
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green