A team of researchers found optical coherence tomography angiography (OCT-A) is a useful diagnostic tool in assessing eyes with Best disease and associated choroidal neovascularization (CNV). In a study published in the British Journal of Ophthalmology, investigators used OCT-A to find eyes with Best disease had abnormal foveal avascular zones (FAZ), patchy vascularity loss in the superficial and deep layers of the retina and capillary dropout with a hyporeflective center in the choriocapillary layer.

Additionally, the investigators found OCT-A is superior to fluorescein angiography (FA) in measuring CNV.

The prospective observational study included 19 eyes of 10 patients with Best disease. All layers of the retina were qualitatively characterized using OCT-A, while patients with CNV also underwent FA. Areas of CNV were measured by both modalities and correlated. Retinal characteristics revealed 14 (74%) eyes with abnormal FAZ in the superficial layer; 19 (100%) had an abnormal FAZ in deep layers; 11 (58%) had a hyper-reflective center in the superficial layer; 18 (95%) had patchy vascularity loss in the deep layer; 17 (89%) had hyporeflective center in the choriocapillary layer; and 12 (63%) had hyper-reflective material within the hyporeflective center.  

The researchers also noted six (86%) CNV eyes had a “halo,” or a hypolucent area, surrounded by the CNV complex in the outer retinal layer.

Guduru A, Gupta A, Tyagi M, et al. Optical coherence tomography angiography characterisation of Best disease and associated choroidal neovascularization. Br J Ophthalmol. 2018 Apr;102(4):444-7.