Correlation of morphologic changes between optical coherence tomography and topographic angiography in a case of gyrate atrophy

Purpose:To characterize ultrastrructual changes in atrophic disease of the retina, RPE and choroid as seen with gyrate atrophy using two new diagnosti c modalities, optical coherence tomography (OCT) and topographic angiograph y. Patient and method: OCT images were taken in a patient with pericentral cho roidal atrophy using a slit-lamp-adapted OCT system. Ophthalmoscopy, conven tional and topographic angiographic findings were correlated to the reflect ivity changes as seen an OCT. Results:Areas of chorioretinal atrophy correlated with a loss of reflectivi ty in the RPE-choriocapillaris complex on OCT. Additionally OCT identified a thinning of the nerve fiber layer. Topographic angiography demonstrated a n extensive defect, seen as an area of depression, consistent with a loss o f choriocapillaris and larger-sized choroidal vessels. In contrast to conve ntional angiography, central islands were not found to demonstrate structur al intensity, while the midperipheral surrounding area was clearly elevated to physiological levels. Conclusion: OCT and topographic angiography provide in vivo insight into mo rphologic changes within neurosensory retina and choroid caused by pericent ral choroidal atrophy.