Three dimensional spectral domain optical coherence tomography features of retinal-choroidal anastomosis

Background To correlate the three-dimensional (3D) spectral-domain optical coherence tomography (SD-OCT) features of retinal-choroidal anastomosis (RCA) to conventional angiography. Methods This is a retrospective chart review of consecutive patients diagnosed with RCA who underwent 3D SD-OCT between July 2007 and June 2010. Main outcome measures were the diagnostic capabilities of 3D SD-OCT, and the correlation between 3D findings and the features distinguished by conventional angiography. Results Eighteen eyes of 18 patients [five males, 13 females, mean age 79.5±19.4 years (range, 70-93 years)] were included in the analysis. In eyes (n=3) showing a focal staining on angiography, 3D OCT revealed a slight convex prominence of the inner retinal surface in correspondence of a small dome-shaped retinal pigment epithelium (RPE) elevation (which represented the early RCA). In eyes (n=7) showing a "hot spot" without pigment epithelium detachment (PED) on angiography, 3D OCT revealed a convex prominence of the inner retinal surface in correspondence with a well-demarcated prominence of RPE with steep margins (which represented the RCA). In eyes (n=8) showing a "hot spot" with PED on angiography, 3D OCT revealed a convex prominence of the inner retinal surface in correspondence with a convex RPE prominence with a peak at the top. Conclusions 3D SD-OCT provides a map of the retina and RPE, allowing a realistic visualization of the different pathological features in the disease development, and may be able to provide clinically relevant information to complement angiography in the diagnosis of RCA.