September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Optical coherence tomography angiography of choroidal neovascularization in inherited retinal dystrophies
Author Affiliations & Notes
  • Rachel C. Patel
    Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, United States
    University of Massachusetts Medical School, Worcester, Massachusetts, United States
  • Simon S. Gao
    Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, United States
  • Miao Zhang
    Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, United States
  • Talal Alabduljalil
    Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, United States
  • Abdullah Aoun Alqahtani
    Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, United States
  • Yali Jia
    Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, United States
  • David Huang
    Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, United States
  • Paul Yang
    Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, United States
  • Mark E Pennesi
    Casey Eye Institute, Oregon Health and Science University, Portland, Oregon, United States
  • Footnotes
    Commercial Relationships   Rachel Patel, None; Simon Gao, None; Miao Zhang, None; Talal Alabduljalil, None; Abdullah Alqahtani, None; Yali Jia, Optovue, Inc. (F), Optovue, Inc. (P); David Huang, Carl Zeiss Meditec, Inc. (P), Optovue, Inc. (F), Optovue, Inc. (I), Optovue, Inc. (P); Paul Yang, None; Mark Pennesi, AGTC (F), AGTC (C), ISIS Pharmaceuticals (C), Sanofi (F)
  • Footnotes
    Support  This work was supported by the Choroideremia Research Foundation; NIH grants R01 EY023285, R01 EY024544, DP3 DK104397, P30 EY010572; CTSA grant UL1TR000128; Foundation Fighting Blindness grant C-CL-0711-0534-OHSU01; and an unrestricted grant from Research to Prevent Blindness.
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 2163. doi:
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    • Get Citation

      Rachel C. Patel, Simon S. Gao, Miao Zhang, Talal Alabduljalil, Abdullah Aoun Alqahtani, Yali Jia, David Huang, Paul Yang, Mark E Pennesi; Optical coherence tomography angiography of choroidal neovascularization in inherited retinal dystrophies. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2163.

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

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Abstract

Purpose : Optical coherence tomography (OCT) angiography provides a novel, noninvasive method of evaluating retinal vasculature. We performed a retrospective case series of patients with inherited retinal dystrophies (IRD) complicated by choroidal neovascularization (CNV) to determine the clinical utility of OCT angiography in degenerative disorders, characterize angiographic morphology, and perform sequential quantitative analysis concurrent with bevacizumab therapy.

Methods : We identified four IRD patients presenting with choroideremia, EFEMP1-related retinopathy, Best vitelliform macular dystrophy, and adult-onset vitelliform dystrophy (AOVD) and complicated by CNV. They were evaluated with OCT angiography using a 70 kHz spectral domain OCT system employing the split-spectrum amplitude-decorrelation angiography (SSADA) algorithm. Semi-automated segmentation delineated the CNV in each eye and automated software quantified the area and vessel density of the lesion. Two of the four patients (those with choroideremia and EFEMP1-related retinopathy) underwent treatment with intravitreal bevacizumab and were evaluated by OCT angiography at corresponding intervals.

Results : Neovascular flow was observed within areas of subretinal fibrovascular tissue. In the patient with AOVD, fluorescein angiography was indeterminate but OCT angiography demonstrated the presence of flow through the lesion. CNV morphology varied from long vascular loops devoid of fine branches to dense capillary networks. The area of the neovascular vessels ranged from 0.07 to 0.98 mm2. Following intravitreal bevacizumab injection, the visualization of the neovascular capillaries notably decreased while the larger vessels were relatively unchanged.

Conclusions : OCT angiography enables the morphological characterization and quantification of CNV in patients with retinal dystrophies despite distorted retinal architecture, supplementing information derived from fluorescein angiography. Intravitreal bevacizumab may alter CNV architecture particularly by pruning or decreasing flow through capillary branches, but long-term therapy did not result in vascular normalization in our two cases. Serial OCT angiograms may provide morphological and quantitative guidance for treatment of neovascularization.

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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