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Alessandro Invernizzi, Eleonora Benatti, Mariano Cozzi, Stefano Erba, Shiva Vaishnavi, Kiran Vupparaboina, Giovanni Staurenghi, Jay Chhablani, Mark C Gillies, Francesco Viola; Choroidal changes may predict neovascular activity in exudative age related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3253.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To explore the potential use of choroidal changes to predict activation or reactivation of neovascular age-related macular degeneration (nAMD)
Eyes diagnosed with nAMD that had two sequential visits within 12 months showing evidence of inactive then active disease were included. Eyes with “inactive disease” included those with no history of choroidal neovascularization (CNV) and those under treatment for CNV that had received no treatment for 3 months and still had no signs of activity on OCT and fundus fluorescein angiography (FFA). Subfoveal Choroidal thickness (SCT) and mean choroidal thickness (MCT) were manually assessed on enhanced depth imaging OCT. The choroidal vascularity index (CVI), the ratio between the vascular and stromal components of the choroid, was also calculated. These measurements were compared between the inactive and the active stages of the disease. Subgroup analysis accounting for lesion type and previously received treatment were performed.
Sixty-five eyes from 60 patients (35 females, mean age 80±6 (range 66-93)) were included. The mean SCT of inactive lesions was 164±67 mm and MCT was 144±45 mm. The same measurements significantly increased to 175±70 mm and 152±45 mm respectively in active lesions (both p<0.000001). Inactive lesion CVI was 54.5 ± 3.3 %, increasing to 55.4 ± 3.8 % at for active lesions (p=0.04). There were 32 type 1, 17 type 2 and 16 Type 3 lesions. Type 3 lesions had a significantly thinner mean SCT and MCT compared to Type 1 CNVs. The change in SCT and MCT from inactive to active lesions was statistically significant for all the three lesion types. Of the 65 eyes graded as inactive, 22 had no CNV, 34 had previously received ranibizumab and 9 aflibercept. There was no significant difference at Inactive and Active in terms of SCT, MCT and CVI between these three groups.
Choroidal thickness and CVI significantly increased during the active phases disease in eyes with nAMD. Further studies are warranted to evaluate the use of changes in choroidal thickness as a predictor of CNV development or recurrence.
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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