Abstract
Purpose :
To determine whether Optical Coherence Tomography Angiography, OCTa, can be used to help assess the response of neovascular age related macular degeneration, AMD, to anti-Vascular Endothelial Growth Factor, anti-VEGF, treatment.
Methods :
This is a prospective, masked, exploratory study to determine OCTa findings in patients udergoing anti-VEGF therapy for neovascular AMD. Choroidal neovascular membrane, CNVM, size, vascular area, relative vascular area, and location of the CNVM will be characterized by masked readers. Correlations of the above measurements will be made with foveal thickness, height of subretinal fluid, pigment epithelial detachment, and cystoid macular edema on spectral domain OCT as well as visual acuity.
Results :
OCTa accurately determines CNVM size and vascularity during treatment with anti-VEGF for neovascular AMD. Anti-VEGF treatment generally diminishes CNVM size and vascularity in a significant fashion. A subset of patients who respond rapidly to treatment based on neovascular regression on OCTa can be identified, who enjoy a better visual prognosis, similar to the results observed in the original ANCHOR and MARINA studies using fluorescein angiography and time domain OCT. Overall, the degree of reduction of CNVM size and vascularity is associated with recovery of visual acuity throughout treatment for neovascular AMD. Patients with larger CNVM size at presentation overall had a poorer visual prognosis. No significant differences in CNVM characteristics were observed after treatment amongst different anti-VEGF molecules.
Conclusions :
OCTa is a non-invasive diagnostic tool that performs well as a surrogate marker to follow patients undergoing treatment for neovascular AMD. CNVM size measured by OCTa can be correlated to visual acuity at onset of CNVM and throughout treatment for neovascular AMD. Thus, OCTa provides useful information to supplement standard spectral domain OCT analysis during treatment for neovascular AMD, while remaining less invasive and time consuming than typical fluorescein angiography.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.