Abstract
Purpose: :
To evaluate whether the type of vascular morphology on indocyanine green angiography (ICGA) in eyes with age related macular degeneration (AMD) and fibrovascular pigment epithelial detachments (FVPED) predicts response to anti-VEGF induction therapy.
Methods: :
The study is a retrospective review of charts of patients with the fibrovascular PED subtype of neovascular AMD, as determined by FA, fundus photography, and OCT on initial presentation that have also undergone high-speed video ICGA. Images were reviewed to evaluate the ICGA-subtype of FVPED, and data were collected to determine disease activity before and after induction therapy with anti-VEGF therapy (defined as 3-5 injections over 6 months). Cases were identified using a DEDUCE (Duke Enterprise Data Unified Content Explorer) search from January 1, 2005 to November 15, 2009.
Results: :
Thirty-seven patients with fibrovascular PED were identified using the DEDUCE system. The most common type of vascular morphology on presentation was arteriolized vascular complex (AVC) with 38% of patients demonstrating this morphology. This was followed by increased vascularity (22%), and the polypoidal choroidal vasculopathy (PCV) subtype (19%). Twenty patients had post-induction ICG imaging completed. Of these patients, the most common type of vascular morphology after induction was AVC (45%), followed by PCV (25%). Patients with the AVC subtype and the PCV subtype were most likely to be associated with persistent disease activity after induction therapy.
Conclusions: :
The majority of eyes with the FVPED subtype of neovascular AMD demonstrated AVC morphology on ICGA. The AVC and PCV subtypes may be more likely to demonstrate persistent activity after induction with anti-VEGF therapy.
Keywords: age-related macular degeneration • imaging/image analysis: clinical • retina