IOTM: Angioid Streaks with Choroidal Neovascularization by Swept-Source Optical Coherence Tomography Angiography*

Image of the Month (IOTM) is a collection of interesting clinical cases with high quality images for all relevant imaging modalities (ex: color fundus, OCT, OCTA, FAF, FA, En Face, Red-free, choroidal vasculography (CVG), anterior imaging) and other clinical results if relevant (ex: visual field plots). Each case is submitted by an eye care professional using one of Topcon’s industry-leading OCT devices.

Case background

A 31-year-old female patient presented with poor visual acuity in both eyes (OU). BCVA of Counting Fingers at 3 mts in the right eye (OD) and hand movements in the left eye (OS) were measured. Fundus examination showed pigmented lesions arranged in a radiated centrifugal pattern from the optic nerve involving the foveal area in OU, compatible with Angioid Streaks (AS). Superior perifoveal subretinal hemorrhage and macular edema was observed in OS, as illustrated in the mosaic photo (A, B). Multimodal Scanning was performed using the Topcon DRI OCT Triton, Swept Source OCT. Due to the 1050 nm wavelength and the de-correlation analysis technology, it was possible to demonstrate the presence of a subfoveal hyperreflective 0.62 mm2 ball lesion in OD and a subfoveal 8.46 mm2 jellyfish lesion in OS, corresponding to the choroidal neovascular membrane (CNV), as seen in the angiographic outer-retina planes (G, D) and choriocapilaris (E, H). These stand out as a turquoise blue finding in the composite analysis image (C, F) for both eyes. There is also evidence of an active CNV, see B-Scan (J), which indicates that the treatment with Intravitreous Antiangiogenics is appropriate.

Diagnosis:  Angioid Streaks with Choroidal Neovascularization

Captured with:  Topcon DRI OCT Triton

DRI OCT Triton Images

A & B: Color Fundus Mosaic Images 

C–H: OCT-A Images

I & J: Swept Source OCT Image

Images courtesy of Carlos Abdala, MD and Juan Esteban Unigarro, MD of Clinica Unidad Laser del Atlantico Barranquilla, Colombia.

  1. OCT Angiography is not available for sale in the US

The opinions, ideas, views and assumptions expressed are the author’s own and do not necessarily represent the views of Topcon, nor do they constitute advice from Topcon.

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