Optical Coherence Tomography Angiography Findings of Classic Choroidal Neovascularization in Polypoidal Choroidal Vasculopathy.

PURPOSE To evaluate the flow signals in subretinal hyperreflective material (SHRM) that represents classic choroidal neovascularization (CNV) on fluorescein angiography (FA) in eyes with polypoidal choroidal vasculopathy (PCV). METHODS We retrospectively reviewed 20 eyes with PCV that appeared to have classic CNV on FA, accompanied by SHRM on optical coherence tomography (OCT) at the same location. Using OCT angiography (OCTA), we analyzed intrinsic flow signals in the SHRM (cross-sectional B-scans, en-face). The possible association between pretreatment OCTA findings and fibrotic scar formation after anti-vascular endothelial growth factor (VEGF) treatment was evaluated. RESULTS Six of 20 eyes (30%) showed vascular SHRM; the remaining 14 eyes (70%) showed avascular SHRM at the classic CNV site at baseline. The SHRM corresponded with polypoidal lesions seen on indocyanine green angiography in 5 of 6 eyes with vascular SHRM and in all 14 eyes with avascular SHRM. After anti-VEGF treatment, all 6 eyes with vascular SHRM left a fibrotic scar, while all 14 eyes with avascular SHRM showed no scar formation (P < 0.001). CONCLUSION Using OCTA, we evaluated the flow signals in SHRM that represented classic CNV in eyes with PCV and successfully differentiated true type 2 macular neovascularization from pseudo classic CNV.