Abstract
Purpose :
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.
Methods :
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.
Results :
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
Conclusions :
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.