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Ching Jygh Chen, Jordan Burnham; Early Detection of Silent Choroidal Neovascular Membrane in Age-Related Macular Degeneration By Optical Coherence Tomography Angiography. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3254.
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To identify the incidence of silent choroidal neovascular membrane (CNV) in age-related macular degeneration (ARMD), and to study the frequency and duration for a silent CNV to turn active. The clinical significance of the blood flow and the vessel density of the silent and the activated CNV was further evaluated.
Retrospective observational clinical study to review the images of SSADA based OCTA, SD-OCT and FA on patients with ARMD, and to analyze the blood flow, and the vessel density of the silent CNV with Angioanalytics software.
Silent CNV was detected in 19 of 253 ARMD patients (7.5%). Among them, the first group of 10 (53%) remained silent, and group 2 of 9 (47%) CNVs turned active. Mean duration for a silent CNV to turn active was 12.7 months (4-23m). Most common presenting signs were subretinal hemorrhage and leakage on FA, and detection of intra- or subretinal fluid on OCT. Mean CNV blood flow area and vessel density were 0.598mm2 and 55.7% in group 1, 1.288mm2 and 56.4% in CNVs before turning active and 1.745mm2 and 54.19% after turning active in group 2. There were 10 type 1 CNV, 2 type 2 CNV and 7 atrophic without CNV in contralateral eyes
OCTA is capable to detect the silent CNV in ARMD patients without active symptom. About 47% of silent CNVs (Group 2) turn active within the mean duration of 12.7 months. Mean blood flow in group 2 is more than group 1 silent CNV. Mean blood flow in group 2 CNV is significantly more after they turned active. However, there is no significant difference of the vessel density between group 1 and group 2 silent CNV. Application of home self-monitor visual screening device should be advised in the patients with silent CNV. Early detection of a silent CNV by OCTA provides a timely anti-VEGF treatment when it becomes active.
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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