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Ching Jygh Chen, Matt Olsen, Brian Tieu, Jordan Burnham; Evaluating the Response of Type 1 Choroidal Neovasular Membrane in Neovascular Age-Related Macular Degeneration to Anti-VEGF Treatment by Optical Coherence Tomography-Angiography. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1625.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the response of Type 1 CNV in neovascular ARMD to anti-VEGF treatment using OCT angiography (OCTA)
Retrospective review of SSADA-based OCTA images from patients treated with anti-VEGF for neovascular ARMD with type 1 CNV.
37 eyes with type 1 CNV were treated with various anti-VEGF agents. Among them, 10 remained partially active; 7 were refractive to treatment; 10 were responsive with temporary inactivity; and 10 were quiescent for more than one year after treatment. The OCTA detected blood flow in all 37 treated CNVs. In partially active CNV, the size and vascular volume of the CNV varied. The size of the CNV was smaller in partially active and temporarily inactive CNVs compared to refractive CNVs. The CNV responded to anti-VEGF treatment by partial closure of peripheral vascular branches, but the central vascular trunk remained unaffected. Recurrent activity also involved mainly the peripheral branches. In refractive CNV, weekly OCTA showed no to minimal vascular responses. In quiescent CNV, flow change analysis showed a steady vascular flow pattern without changes.
Blood flow was detected by OCTA in all treated CNVs regardless of their clinical response to anti-VEGF treatment. The treatment goal for neovascular ARMD should not be a complete resolution of the CNV. Instead, the main aim may be turning an exudative type to a non-exudative CNV. The role of OCTA alone in the management of neovascular ARMD still needs further study.
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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