Detection of pigment epithelial detachment vascularization in age-related macular degeneration using phase-variance OCT angiography

PURPOSE To demonstrate the use of phase-variance optical coherence tomography (PV-OCT) angiography for detection of pigment epithelial detachment (PED) vascularization in age-related macular degeneration (AMD). PATIENTS AND METHODS Patients with PEDs and exudative AMD were evaluated by the Retina Services at the University of California, Davis, and the University of California, San Francisco. Each subject underwent fluorescein angiography and structural optical coherence tomography (OCT). Phase-variance OCT analysis was used to create angiographic images of the retinal and choroidal vasculature. PV-OCT-generated B-scans were superimposed on structural OCT B-scans to allow easy identification of perfused vascular structures. RESULTS Three patients with vascularized PEDs were imaged with PV-OCT, and each was found to have a vascular signal extending from the choroid into the hyperreflective substance of the PED. Two patients who had no evidence of PED vascularization on fluorescein angiography did not have vascular signals within their PEDs on PV-OCT. CONCLUSION Structural OCT and PV-OCT images can be combined to create composite B-scans that offer high-resolution views of the retinal tissue along with dynamic vascular visualization. This technique offers a fast, noninvasive method for detecting vascularization of PEDs in AMD and may aid in the early detection of neovascular disease.