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Marco Lupidi, Florence Coscas, Fiore Tito, Carlo Cagini, Gabriel J Coscas; OCT-Angiography Assessment Of CNV Evolution In Treated Exudative AMD: An Analysis Based On Activity Criteria. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1608.
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© 2017 Association for Research in Vision and Ophthalmology.
To describe and analyze optical coherence tomography angiography (OCT-A) findings, based on Activity Criteria, in treatment-naive exudative AMD (eAMD) before and after VEGF-trap intravitreal injections.
Prospective case series of 60 eyes of 60 consecutive treatment naïve eAMD patients (36 females, mean age 74.4 ± 6.2 years) diagnosed with different types of CNV (41 type I, 2 type II, 9 mixed type I-II, 3 type III, 5 AMD-related polyps) and evaluated by conventional multimodal imaging andSpectralis OCT-A (Heidelberg Engineering, Heidelberg, Germany).A micro-structural analysis, based on 5 Activity Criteria (shape, branching pattern, presence of anastomoses, vessel’s termini and presence of perilesional halo) was performed to achieve the treatment-induced changes in choroidal neovascularization (CNV) morphology. The CNV area and greatest linear dimension (GLD) were measured along with the variation in subretinal and/or intraretinal fluid.
After treatment the morphological analysis of the CNV features on OCT-A showed, in the largest part of the lesions, a reduction in the visibility of tiny branching vessels, mainly present at the periphery of the lesion, of the anastomoses and small peripheral arcades. Moreover 95% of patients with initial exudative reaction on OCT, showed a decrease in the amount of fluid. Fifty-three (53) out of 60 patients demonstrated decreases in CNV GLD and area with an average reduction of 13% and 24% respectively. There was high (p< 0.05) inter-observer agreement both for morphological and quantitative OCT-A imaging analysis.
OCT-A is a useful technology for non-invasive monitoring of the exudative AMD because both functional (blood flow) and morphological (fluid accumulation) information is provided from a single scan. Such monitoring, based on Activity Criteria and quantitative findings, may help in the diagnosis of CNV, guiding decisions for treatment, as well as in monitoring the evolution of CNV and its response to treatment.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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