Peripapillary Intrachoroidal Cavitation in Myopia Evaluated with Multimodal Imaging Comprising “En-Face” Technique

Abstract EN

Objectives.

To demonstrate the usefulness of “en-face” Spectral Domain Optical Coherence Tomography (SD-OCT) combined with Fluorescein Angiography (FA) in the investigation of peripapillary intrachoroidal cavitation.

Materials and Methods.

A 72-year-old man followed for primary open-angle glaucoma (POAG) for 4 years was referred for an asymptomatic “peripapillary lesion.” A full ophthalmological examination and conventional imaging of the retina were done.

FA, Indocyanine Green Angiography (ICG-A), and SD-OCT using the “en-face” technique were also performed.

Results.

Best-corrected visual acuity (BCVA) was 20/25 both eyes.

Slit-lamp examination revealed no abnormalities of anterior segment.

Intraocular pressure (IOP) was normal.

Fundus examination showed a triangular yellow-orange thickening at the inferior border of both optic nerves.

FA showed early hypofluorescence of the lesion and progressive staining without any dye pooling.

SD-OCT with “en-face” technique showed an intrachoroidal hyporeflective space resembling a cavitation below the retinal pigment epithelium (RPE).

Conclusions.

“En-face” SD-OCT and FA are valuable techniques for the diagnosis of peripapillary intrachoroidal cavitation associated with myopia.

Pathophysiological insights regarding SD-OCT findings and angiography behavior are offered.