Abstract
Purpose :
To describe the optical coherence tomography angiography (OCTA) features of active inflammatory choroidal neovascularization (CNV) and characterize the early responses of anti-vascular endothelial growth factor (VEGF) treatment for inflammatory CNV.
Methods :
OCT angiography images of inflammatory CNV were acquired and analyzed using the RTVue XR Avanti with AngioVue at baseline as well as fluorescein angiography and spectral-domain optical coherence tomography (SD-OCT). OCTA scans were sequentially obtained 1 day before treatment, 1 day, 7 days, 14 days and 30 days after anti-VEGF injection. Changes of the selected area and flow area of CNV on OCTA were measured along with those of the central macular thickness (CMT) on corresponding SD-OCT.
Results :
19 eyes of 18 uveitic patients (mean age: 36.83 ± 10.05 years) presenting with active CNV were included in the prospective case series. The OCTA showed a 100% sensitivity for inflammatory CNV detection in 23 of 23 CNV lesions, revealing prevailing two neovascular phenotypes: vascular loops and intertwined nets. After anti-VEGF injection, as early as the 1-day follow-up, the mean selected area and the mean flow area of inflammatory CNV on OCTA were significantly reduced (both P< 0.05) while the average CMT on SD-OCT did not change until the 7-day follow-up. OCTA was able to detect the reincrease of capillary density and vessel size predominantly in the second phenotype 14-30 days after anti-VEGF injection.
Conclusions :
OCTA not only allows for noninvasive detection of inflammatory CNV with a high sensitivity but also facilitates its sequential observation after anti-VEGF treatment. The treatment outcomes are observable at day 1 post treatment. OCTA may be a useful tool for diagnosing inflammatory CNV and evaluating the early response to anti-VEGF treatment.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.