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Jiyoung Lee, Hyungwoo Lee, Hyewon Chung, Hyung chan Kim; Changes in Fundus Autoflourescence After Intravitreal Anti-VEGF according to the Type of Neovascular Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3399. doi: https://doi.org/.
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To describe the changes of autofluorescence (FAF) in patients with age-related macular degeneration (AMD) before and after intravitreal anti- vascular endothelial growth factor(VEGF) treatment according to the type of choroidal neovascularization (CNV) and to analyze the correlation with the relationship between spectral domain-optical coherence tomography(SD-OCT) parameters and vision.
Twenty-one treatment naïve patients with neovascular AMD were included in this study (14 eyes of type 1 and 7 eyes of type 2 CNV). All eyes underwent a complete ophthalmologic examination, including the assessment of best-corrected visual acuity, SD-OCT, fluorescein angiography (FA), and FAF imaging, before and 3 months after intravitreal anti-VEGF injection. Gray scales of FAF image for CNV areas as delineated in FA were analyzed using imageJ program, which were adjusted by comparison with normal background areas (4 random lesions at extrafovea). Correlation of changes in SD-OCT parameters including CNV height, inner segment/outer segment (IS/OS) disruption length, external limiting membrane(ELM) disruption length, central macular thickness(CMT), subretinal fluid(SRF), and intraretianl fluid (IRF) and changes in FAF was analyzed.
Eyes with both type 1 and type 2 CNV with SRF or IRF showed reduced FAF before treatment (mean grey scale value 45.36 and 41.81; background value 106.2 and 108). The mean grey scale vaule of patients with type 1 CNV was changed to 54.38, and that of patients with type 2 CNV was 58.04, after treatment. The increase of FAF after treatment from originally low FAF was more prominent in type 2 than type 1 CNV. After treatment, CNV height, CMT and IS/OS disruption length were decreased, along with the increase of FAF.
FAF of both types of CNV with SRF before treatment was low. With treatment, FAF of type 2 CNV tends to increase more toward normal FAF than that of type 1 CNV, correlating the decrease of CNV size, CMT and IS/OS disruption length. These findings indicate that the function of RPE in both types of CNV, could be preserved if treated promptly.
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