Malattia Leventinee Case Study

Choroidal neovascularization in MalattiaLeventinesediagnosed using Optical Coherence Tomography Angiography
Rita Serra, (1, 2), Florence Coscas,(1), Nabil Messaoudi, (1), Mayer Srour, (1), Eric Souied, (1)
1 Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil University Paris Est Creteil, Creteil, France
2 Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy

Corresponding author: Florence Coscas, Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil, 40 Avenue de Verdun, 94000 Creteil, France
Tel: [phone]
Fax: [phone]
Email:[e-mail].

Short title:OCT Angiography and CNV in Malattia Leventinese

INTRODUCTION
Malattia Leventinese (ML) is a genetically

His BCVA was 20/25 in the RE and 20/20 in the left. The anterior segment and intra-ocular pressure(IOP) was normal in both eyes.

Fundus examination of the RE showed yellow white drusen of different sizes located in the macular and peripapillary areas. The larger drusen were roundish, confluent, and located mainly around the macular area; most of these drusen were ill-defined with blurred borders. The smaller drusen were mainly visible in the peripheral part of the lesion and radially arranged. Pigmentary changes including mottling and focal atrophy were observed in the macular area.

FA showed central masking with heterogeneous hyperfluorescence compared to the large drusen and staining without leakage. ICGA revealed, in the early phase, a hypofluorescent zone with ill-defined borders corresponding to the location of the large
Paracentral drusen surrounding the macular area. In the late phase, the large round shaped drusen appear as hyperfluorescent spots surrounded by hypofluorescent halos. No hyperfluorescent areas suggestive of active CNV was observed in the late phase.

FA and ICGA showed the small radial drusen as areas of hyperfluorescence in the early phase that decreased during the late phase in both FA and ICGA. On the contrary, large drusen showed a hyperfluorescence, in the early phase that increased in the late phase of FA while on ICGA they were hypofluorescent in the early phases with a characteristic hyperfluorescent pattern in the late phases. No characteristic features of CNV were found on either FA or ICGA. (Fig. 7)
SD-OCT showed diffuse deposition of hyperreflective material between the RPE and the Bruch’s membrane resulting in diffuse RPE elevation. Additionally, we observed a focal serous retinal detachment associated with hyperreflective dots in the interdigitation zone of the foveal region. The OCT-A choriocapillaris segmentation showed a high flow structure composed of filamentous linear vessels, forming anastomoses and loops, associated with a peripheral arcade surrounded by a dark halo. (Fig. 8)

Case