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Introduction
Fluorescein angiography (FA) was for decades the standard diagnostic adjunct for studying macular diseases and their manifestations, especially choroidal neovascularisation (CNV). Recently, optical coherence tomography (OCT) has emerged as a non-invasive alternative for diagnosing chorioretinal diseases, with enhanced specificity and sensitivity, particularly for vitreoretinal interface and exudative macular abnormalities. However, studies have shown that leakage demonstrated with FA, cannot always be detected with OCT. 1 2
We evaluated patients with CNV secondary to multifocal choroiditis (MFC) with FA and OCT, and characterised the nature of the CNV and the concordance between these two diagnostic modalities in detecting it.
Methods
We conducted a retrospective analysis of consecutive, symptomatic patients with MFC in a referral practice. The objective of the study was to evaluate the clinical characteristics and nature of CNV in this idiopathic inflammatory retinal condition and to compare the utility of the diagnostic adjuncts, FA and OCT. The patients were either evaluated at the Vitreous-Retina-Macular Consultants of New York or at the First Department of Ophthalmology of the Medical School of Athens University, between May 1999 and March 2008. Fundus photography, FA, OCT and slit-lamp biomicroscopy were used to establish the diagnosis of MFC based on the characteristic retinal morphology of multiple punched-out, chorioretinal atrophic spots located in the posterior pole or mid-periphery in association with signs or clinical history of vitreous and anterior chamber inflammation. Supplemental serological studies were employed as clinically indicated to exclude other systemic medical diseases with similar ocular inflammatory presentations.
Only patients with a diagnosis of MFC who exhibited acute visual deficits and clinical manifestations of active CNV were included in the study. The active CNV was diagnosed by biomicroscopy and the typical findings seen on FA such as early hyperfluorescence with late dye leakage. Disciform scars at separate sites than the active CNV, in the same or fellow eye, were not included. Other exclusion criteria were: features of other neovascular maculopathies such as age-related macular degeneration; hereditary retinal disorders or idiopathic CNV; previous therapeutic interventions such as submacular surgery, laser photocoaguation, photodynamic therapy (PDT) or anti-vascular endothelial growth factor (anti-VEGF) pharmacotherapy; and underlying ocular or systemic inflammatory or infectious diseases such as presumed ocular histoplasmosis (POHS,) tuberculosis and sarcoidosis.
Each patient received a comprehensive ophthalmic examination which...