Abstract
Purpose :
To propose a classification into immature and mature choroidal neovascularisation on OCTA and assess association between these phenotypes with chronicity and treatment history
Methods :
A retrospective cohort study was undertaken. A database of patients who underwent swept source OCTA with the Topcon Triton device was reviewed. Inclusion criteria was patients with a diagnosis of nAMDand visible CNV on OCTA. Electronic patient records were then reviewed to obtain date of diagnosis, visual acuity at the time of OCTA, if anti-VEGF treatment history and number of injections given. Morphology of the CNV was noted. CNV was classified as immature if there was a dense vascular network with multiple small vascular branches and a smooth outline. CNV was classified as mature if the vessel network was disorganised, with larger vessels separated by large dark spaces without smaller branching vessels between them.
Results :
29 patients and 32 eyes included. Mean age was 80.4 years (SD 8.5 years). 12 eyes were said to have immature CNV, 20 eyes were said to have mature CNV. Of those characterised as immature CNV median time from date of diagnosis and OCTA was 0.0 months (range 0-87 months), and the majority (7 of 12) were treatment naive. Median number of injections in this group was 15. Of those characterised as having mature CNV median time from date of diagnosis toOCTA was 18 months (range 0-84) and 12 had undergone treatment (median number of injections 11.5). In the mature group 2 eyes were newly diagnosed with nAMD at the time of OCTA but were thought to be chronic neglected lesions. There was a statistically significant difference in time from diagnosis to OCTA (p=0.06), but no difference in the number of patients who had been treated (p=0.21), number of injections given (p=0.29) or visual acuity at time of OCTA (p=0.31) between the two groups.
Conclusions :
Mature and immature CNV could be differentiated based on OCTA morphology. Although mature appearance was mostly associated with more chronic lesions, treatment status was not shown to be associated with morphology. Cases of mature, yet treatment-naive lesions as well as immature yet extensively treated lesions were identified.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.