RETINAL DISORDERS The use of optical coherence tomography angiography in pachychoroid spectrum diseases: a concurrent comparison with dye angiography Sibel Demirel 1 & Özge Yanık 1 & Hilal Nalcı 1 & Figen Batıoğlu 1 & Emin Özmert 1 Received: 8 May 2017 /Revised: 18 August 2017 /Accepted: 28 August 2017 # Springer-Verlag GmbH Germany 2017 Abstract Purpose The study objective was to compare dye angiogra- phy and optical coherence tomography angiography (OCTA) in detecting choroidal neovascuarization (CNV) in patients presenting with pachychoroid features and flat irregular pig- ment epithelial detachment (PED). Methods Nineteen eyes of 17 patients, presenting with flat PED and pachychoroid features, and without age-related macular degeneration or any other degenerative change, were analyzed. Fuorescein angiography (FA)/Indocyanine green angiography (ICGA) and OCTA were performed during the same visit. Subfoveal choroidal thickness was measured by enhanced depth imaging using spectral domain optical coherence tomography. Results The mean age of the patients was 59.1 years. Mean subfoveal choroidal thickness was 388 μm. FA revealed non-patognomic features including RPE alterations, win- dow defects, leaking points and leakage from an undeter- mined source. ICGA revealed choroidal vascular plaque in eight eyes (42%) and suspicious plaque in five eyes (26%). Nonneovascular features, such as hyperpermeability or dilated choroidal vessels, were observed in six eyes (32%). OCTA showed choroidal neovascularization in 14 (74%). For all of the eyes, which ICGA was positive for presence of CNV, OCTA also showed CNV, and in one case it also revealed polypoidal characteristics of the neovascular network. OCTA was also able to detect CNV in all of the eyes with suspicious plaque, and in one eye without CNV appearance using ICGA. Conclusions OCTA demonstrated greater sensitivity in de- tecting type 1 CNV than conventional dye angiography in cases with pachychoroid spectrum disease. Keywords Flat irregular retinal pigment epithelium detachment . Optical coherence tomography angiography . Indocyanine green angiography . Pachychoroid neovasculopathy Introduction Pachychoroid-related macular disorders are a spectrum of diseases that share common features, such as increased choroidal thickness and dilated outer choroidal vessels [1]. This spectrum includes four different clinical entities; pachychoroid pigment epitheliopathy (PPE), central serous chorioretinopathy (CSCR), pachychoroid neovasculopathy (PNV), and polypoidal choroidal vasculopathy (PCV) [2]. PPE is the new term used to define a permanent and abnormal increase in choroidal thickness, often manifesting as dilatation of the large outer oval choroidal vessels (Haller’s layer), and which compress the overlying choriocapillaris and Sattler’s layer without causing subretinal fluid (SRF) [2–4]. Pachychoroid neovasculopathy is a recently proposed clinical entity in choroidal neovascularization (CNV) [5]. It has the features of type 1 neovascularization and choroidal thickening in the absence of characteristic age-related macular degenera- tion (AMD) or degenerative change. Pachychoroid spectrum diseases may show pigment epithelium detachments (PED) in variable shape and size. Pigment epithelium detachments were seen in more than two thirds of the CSCR [6]. While acute CSCR usually * Sibel Demirel drsibeldemireltr@yahoo.com.tr 1 Department of Ophthalmology, Ankara University Faculty of Medicine, Vehbi Koç Göz Hastanesi, Mamak Caddesi, Dikimevi, Ankara, Turkey Graefes Arch Clin Exp Ophthalmol DOI 10.1007/s00417-017-3793-8