Using Multicolor Imaging to Detect Polypoidal Choroidal Vasculopathy
By Jean Shaw
Selected By: Andrew P. Schachat, MD
Journal Highlights
Ophthalmology Retina, May 2019
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Multicolor imaging is a novel technology that can be used to visualize pathology in the posterior pole. Images are produced separately from three color wavelengths and can be combined to produce a composite image. Tan et al. evaluated the ability of multicolor imaging to discern features of polypoidal choroidal vasculopathy (PCV) and compared those results with those seen on standard color fundus photography and indocyanine green (ICG) angiography, the gold standard. They found that multicolor imaging could detect features suggestive of PCV, making it a useful noninvasive imaging option, particularly if ICG angiography is not available.
For this cross-sectional study, the researchers assessed 50 consecutive treatment-naive patients (50 eyes) with PCV. Patients were evaluated with multiple imaging technologies, including multicolor imaging, fluorescein and ICG angiography, and color fundus photography. Each patient underwent all imaging modalities on the same day. One eye was selected for analysis. The color fundus and ICG angiography images were independently graded by retina specialists to identify the presence of polyps and distinguish lesion components.
Overall, the researchers found that the location and shape of lesions detected with multicolor imaging correlated well with those seen on color fundus photography and ICG angiography. Multicolor imaging was able to detect polyps in 49 of the 50 eyes (98%). Other clinical features detected via multicolor imaging included branching vascular network (BVN, seen in 60% of eyes), drusen (seen in 66% of eyes), and subretinal hemorrhages (seen in 40% of eyes). On the multicolor composite images, the polyps appeared as dark green oval lesions. When infrared reflectance imaging was used, the polyps appeared as dark grey oval lesions with distinct margins. Subretinal hemorrhages appeared red on the multicolor composite images, while BVNs typically appeared as an area of mottling.
The authors noted that optical coherence tomography (OCT) and OCT angiography were not used in this study, which opens the door to follow-up research on whether the combination of OCT and multimodal imaging would increase diagnostic accuracy.
The original article can be found here.