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Elisabetta Pilotto, Anna Rita Daniele, Francesca Guidolin, Enrica Convento, Evelyn Longhin, Raffaele Parrozzani, Edoardo Midena; Early OCT Angiography changes of type 1 choroidal neovascularization secondary to AMD treated with anti-VEGF. Invest. Ophthalmol. Vis. Sci. 2017;58(8):17. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate with optical coherence tomography angiography (OCTA) the short term changes of type 1 choroidal neovascularizations (CNV), secondary to exudative AMD, treated with anti-VEGF.
From November 12, 2015 to December 24, 2015, patients aged more than 50 years and affected by type 1 CNV treated with intravitreal anti-VEGF were consecutively enrolled. All patients underwent OCTA examination before and 48 hours after the intravitreal anti-VEGF injection, using the Nidek RS-3000 Advance device (Nidek, Gamagori, Japan). Exclusion criteria were: the presence of peripapillary CNV, large size CNV (> 6 DD), geographic atrophy, or optical media opacities which could interfere with the OCT image quality were exclusion criteria.Macular cystoid edema (ME), retinal pigment epithelium detachment (PED) and neuroretinal detachment (ND) changes were evaluated at the OCT horizontal linear scan centered into the fovea. CNV area change was measured on OCTA image. Moreover, fine vessels density, largest vessels caliber and chororiocapillaris hypoperfusion (flow void signal surrounding the vascular lesion) were evaluated on OCT A images. Two independent masked operators evaluated the studied parameters.
Sixteen eyes of 16 patients were evaluated. Eleven patients were treated with Aflibercept and five patients with Ranibizumab. CNV mean area significantly decreased (from 9.65 ± 4.23 mm2 at baseline, to 8.64 ± 4.16 mm2 after treatment, p=0.0004). ME (4 cases) decreased in all cases. NE detachment decreased in 85% (11/13) and RPE detachment decreased in 81% (13/16 ) cases. The density of fine vessels decreased in 75% (12/16) of cases, remained stable in 18.75% (3/16) and increased in 1 case. The caliber of the largest vessels remained stable in 56.25% (9/16) of cases, increased in 18.75% (3/16) and decreased in 12.5% (2/16) of cases. The area of choriocapillaris hypoperfusion, present at baseline in 8 eyes (50% of cases), increased in 62,5% (5/8) and remained stable in the remaining cases. No statistically significant differences were found in the qualitative (Fisher’s exact test) or in the quantitative (Student’s t-test ) analysis made by the two operators on the OCT angiography images.
OCT angiography is useful to reveal early changes of CNV treated with anti-VEGF, allowing a noninvasive and reproducible analysis of the remodeling of vascular network during treatment.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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