June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Correlation of Vascular Impairment with Geographic Atrophy Progression Analyzed with Swept Source OCT Angiography and Variable Interscan Time Analysis
Author Affiliations & Notes
  • Ivana N Despotovic
    New England Eye Center at Tufts Medical Center, Boston, Massachusetts , Boston, Massachusetts, United States
  • Eric M. Moult
    Department of Electrical Engineering and Computer Science, and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts, Cambridge, Massachusetts, United States
  • Carl B Rebhun
    New England Eye Center at Tufts Medical Center, Boston, Massachusetts , Boston, Massachusetts, United States
  • Stefan B. Ploner
    Pattern Recognition Lab, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany, Erlangen, Germany
  • Jennifer Zacharia
    New England Eye Center at Tufts Medical Center, Boston, Massachusetts , Boston, Massachusetts, United States
  • A. Yasin Alibhai
    New England Eye Center at Tufts Medical Center, Boston, Massachusetts , Boston, Massachusetts, United States
  • Carlos Moreira
    New England Eye Center at Tufts Medical Center, Boston, Massachusetts , Boston, Massachusetts, United States
  • ByungKun Lee
    Department of Electrical Engineering and Computer Science, and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts, Cambridge, Massachusetts, United States
  • Caroline R Baumal
    New England Eye Center at Tufts Medical Center, Boston, Massachusetts , Boston, Massachusetts, United States
  • Philip J Rosenfeld
    Bascom Palmer Eye Institute Univ of Miami Miller Sch of Med, Miami, Florida, United States
  • Jay S Duker
    New England Eye Center at Tufts Medical Center, Boston, Massachusetts , Boston, Massachusetts, United States
  • James G Fujimoto
    Department of Electrical Engineering and Computer Science, and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts, Cambridge, Massachusetts, United States
  • Nadia Waheed
    New England Eye Center at Tufts Medical Center, Boston, Massachusetts , Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Ivana Despotovic, None; Eric Moult, None; Carl Rebhun, None; Stefan Ploner, None; Jennifer Zacharia, None; A. Yasin Alibhai, None; Carlos Moreira, None; ByungKun Lee, None; Caroline Baumal, Allergan (C), Genentech (C); Philip Rosenfeld, Carl Zeiss Meditec (F), Carl Zeiss Meditec (C), Carl Zeiss Meditec (R); Jay Duker, Carl Zeiss Meditec, Inc. (F), Carl Zeiss Meditec, Inc. (C), Optovue, Inc (F), Optovue, Inc (C), Topcon Medical Systems, Inc (F), Topcon Medical Systems, Inc (C); James Fujimoto, Carl Zeiss Meditec (P), Optovue, Inc. (I), Optovue, Inc. (P); Nadia Waheed, Carl Zeiss Meditec, Inc. (R), Genentech (C), Janssen (C), Nidek (R), Ocudyne (C), Optovue, Inc. (R), Regeneron (C)
  • Footnotes
    Support  National Institutes of Health: 5-R01-EY011289-28, Air Force Office of Scientific Research: FA9550-15-1-0473, FA9550-10-1-0551, Macula Vision Research Foundation
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 57. doi:
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      Ivana N Despotovic, Eric M. Moult, Carl B Rebhun, Stefan B. Ploner, Jennifer Zacharia, A. Yasin Alibhai, Carlos Moreira, ByungKun Lee, Caroline R Baumal, Philip J Rosenfeld, Jay S Duker, James G Fujimoto, Nadia Waheed; Correlation of Vascular Impairment with Geographic Atrophy Progression Analyzed with Swept Source OCT Angiography and Variable Interscan Time Analysis. Invest. Ophthalmol. Vis. Sci. 2017;58(8):57.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Optical coherence tomography angiography (OCTA) enables visualization of the choriocapillaris (CC). Recently our group developed a novel OCTA algorithm, termed variable interscan time analysis (VISTA), which allows display of relative blood flow speed. In this study we evaluated CC alterations cross-sectionally and longitudinally in patients with geographic atrophy (GA) in nonexudative age-related macular degeneration (AMD).

Methods : Data was collected using a 1050nm, 400kHz swept source OCT system. VISTA was used to calculate relative flow speeds using 1.5ms and 3.0ms interscan times.

Results : Seven eyes of 5 patients with GA secondary to nonexudative AMD were evaluated. (79.4±8.3 y/o; all Caucasians; 2 male, 3 female). Four eyes were evaluated at one visit, and 3 eyes had follow-up scans. Mean follow-up duration for the 3 eyes was 14 months (range 7 to 20 months). In all 7 eyes, OCTA revealed marked CC alteration in the area of GA, as well as CC flow alterations extending beyond the GA border. The changes outside the region of GA were classified as: minimal CC loss with some areas of decreased blood flow speed (14.28%), and diffuse CC loss and decreased blood flow speed (85.71%).

Conclusions : We found severe CC alterations underlying areas of GA, and diffuse CC alterations, including regions of slower blood flows, beyond the GA margins in some patients. Further longitudinal data is needed to evaluate the pattern of GA progression and determine whether areas of CC flow impairment are predictive of the direction of GA enlargement.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

92 y/o GA eye. (A.1) Color fundus photo. (A.2) Sub-retinal pigment epithelium (RPE) OCT slab. (A.3) CC OCTA image. (A.4) CC VISTA-OCTA image. The margin of atrophy was traced (white contour) on the sub-RPE slab, and overlaid on the OCTA and VISTA-OCTA images. OCT data was taken over 6x6mm field. For VISTA image, red (blue) indicates faster (slower) blood flow speeds.

92 y/o GA eye. (A.1) Color fundus photo. (A.2) Sub-retinal pigment epithelium (RPE) OCT slab. (A.3) CC OCTA image. (A.4) CC VISTA-OCTA image. The margin of atrophy was traced (white contour) on the sub-RPE slab, and overlaid on the OCTA and VISTA-OCTA images. OCT data was taken over 6x6mm field. For VISTA image, red (blue) indicates faster (slower) blood flow speeds.

 

76 y/o GA eye at (A) baseline visit, and (B) ~7 month follow-up. (A-B.1) Sub-retinal pigment epithelium (RPE) OCT slab; red circles indicate control points used to register images. (A-B.2) CC OCTA image. (A-B.3) CC VISTA-OCTA image. The margin of atrophy was traced (white contour) on the sub-RPE slab and overlaid on the OCTA and VISTA-OCTA images. For VISTA images, red (blue) indicates faster (slower) blood flow speeds.

76 y/o GA eye at (A) baseline visit, and (B) ~7 month follow-up. (A-B.1) Sub-retinal pigment epithelium (RPE) OCT slab; red circles indicate control points used to register images. (A-B.2) CC OCTA image. (A-B.3) CC VISTA-OCTA image. The margin of atrophy was traced (white contour) on the sub-RPE slab and overlaid on the OCTA and VISTA-OCTA images. For VISTA images, red (blue) indicates faster (slower) blood flow speeds.

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