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Alexandra Miere, Giuseppe Querques, Oudy Semoun, Francesca Amoroso, Olivia Zambrowski, thibaut Chapron, Vittorio Capuano, Eric Souied; Optical coherence tomography angiography changes in early type 3 neovascularization after anti-VEGF treatment. Invest. Ophthalmol. Vis. Sci. 2017;58(8):377.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the morphological changes after anti-vascular endothelial growth factor (VEGF) therapy of treatment naive type 3 neovascularization secondary to exudative age-related macular degeneration (AMD), using optical coherence tomography angiography (OCTA).
In this retrospective study we included consecutive patients diagnosed with treatment-naïve early-stage type 3 neovascularization. All patients underwent fluorescein angiography (FA), indocyanine green angiography (ICGA), structural spectral-domain (SD)-OCT, and OCTA Optovue RTVue® XR Avanti (Optovue, Freemont, California, USA) at baseline, and repeated OCTA and structural SD-OCT at month 12. 3x3 OCTA examinations at baseline and month 12 were then compared, in order to qualitatively assess changes after anti-VEGF therapy.
Fifteen treatment-naïve eyes of 15 consecutive patients were enrolled in the analysis. At 12 months follow-up after pro-re-data anti-VEGF therapy (5.75+/-1.48 injections of Ranibizumab, and 6.33+/- 1.21 injections of Aflibercept), OCTA demonstrated persistence of the deep capillary plexus abnormalities in 13/15 eyes. In the outer retina and choriocapillaris segmentations the initial lesion became undetectable in 7/15 cases, accompanied by choriocapillaris atrophy. The abnormal vascular complex persisted in the form of a tuft-shaped lesion in the outer retinal segmentation in 9/15 eyes, which in the choriocapillaris segmentation was associated with sub-RPE neovascularization in 8 cases.
OCTA showed that the tuft-shaped abnormal outer retinal lesion, frequently associated to a small clew-like flow signal in the choriocapillaris, either becomes undetectable or develops sub-RPE neovascularization after 1 year of anti-VEGF therapy.
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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