Atypical outer retinal fluid accumulation in choroidal neovascularization: a novel OCT finding

Background and objective: To report a novel optical coherence tomography (OCT) finding in choroidal neovascularization (CNV).

Patients and methods: The authors identified seven eyes with CNV demonstrating the atypical pattern of fluid accumulation within the outer retina on OCT. Patient demographics, best corrected visual acuity and spectral-domain OCT (SD-OCT) images were collected for all available follow-up visits. Volume and area of the fluid were measured on SD-OCT. Microperimetry was performed in one case.

Results: The outer retinal fluid was located between the external limiting membrane (ELM) and the outer photoreceptor band on SD-OCT. Within this area, the outer segments of the photoreceptors were visualized as a continuous band, which appeared to split from the retina, dropping down toward the retinal pigment epithelium (mean area: 2.53 ± 1.23 mm(2); mean volume: 0.19 ± 0.20 mm(3)). All cases demonstrated the finding only at one time point during follow-up. Recovery of the outer retina and retinal function could be detected.

Conclusion: Atypical intraretinal fluid accumulation externally to the ELM may be detected on SD-OCT in eyes with CNV. This finding may be transient and may not preclude subsequent improvement in visual function. The frequency of the presumed photoreceptor delamination and its full clinical significance remain to be defined.