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Reinhard Told, Andreas Pollreisz, Gregor Sebastian Reiter, Lorenz Wassermann, Tamara Jasmin Mittermueller, Guenther Weigert, Stefan Sacu, Ursula Schmidt-Erfurth; Superficial retinal plexus reaction to intravitreal ocular medication in patients with nAMD assessed by SD- and SS-OCTA. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3248. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the longitudinal reaction of the superficial and deep retinal plexus as well as the FAZ during a three month loading-phase with intravitreal aflibercept in patients with nAMD using SS- and SD-OCTA.
Twenty eyes of 18 patients with treatment-naïve type 1 or type 2 nAMD were included in this ongoing observational study. Patients were closely followed during the first 3 months after diagnosis using FA, ICGA and OCT/-A. OCTA was acquired at day 1, 3, 7, 14 after the first intravitreal aflibercept injection, respectively. During months two and three, patients returned at day 7 and 14 after IVOM. 6x6 mm SS- (Zeiss, PlexElite) and SD-OCTA (OptoVue, AngioVue) images were acquired and superficial and deep vascular plexus vessel density (VD) in the inner ring of the ETDRS grid were analyzed. The foveal avascular zone (FAZ) area was delineated automatically and manually.
Mean patient age was 75 ± 9 years and 65% were women. 65% of eyes had a mixed type of choroidal neovascularization (CNV), 35% were classic and occult CNV lesions. Superficial and deep VD did not change statistically significantly during the three month follow-up in both SS- and SD-OCTA (p>0.05 ANOVA). However, an initial decrease of superficial VD was seen following IVOM, which was more pronounced in SS- (7%) compared to SD-OCTA (4%). Automatically delineated FAZ area in SS-OCTA did not show a significant change over time (p=0.036). However, in SD-OCTA FAZ increased by a mean of 8 ± 4.5% over time. This trend was diminished in manually delineated SD-OCTA FAZ.
Patients with neovascular AMD show a distinct decrease of the superficial vascular plexus VD during the first three months, which is more pronounced in SS-OCTA compared to SD-OCTA, suggesting a possible reaction of the superficial and deep vascular plexus to treatment in the course of the disease. Significant longitudinal changes in SD-OCTA FAZ were diminished after manual correction. Differences between SS- and SD-OCTA evaluations should be considered when planning longitudinal studies using multiple OCTA devices.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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