Abstract
Purpose :
To qualitatively and quantitatively describe the changes in choroidal neovascularization (CNV) flow pattern after anti-vascular endothelial growth factor (anti-VEGF) therapy, by means of optical coherence tomography angiography (OCTA).
Methods :
Consecutive patients with neovascular age-related macular degeneration (AMD) underwent multimodal imaging, including OCTA at baseline and at last visit. High flow networks in the choriocapillaris segmentation of OCTA were qualitatively and quantitatively analyzed at baseline and at follow up, in order to characterize vascular flow changes after anti-VEGF treatment and to correlate these changes with final exudation signs on SD-OCT.
Results :
Seventeen eyes were included. Mean follow-up was of 11.7 +/- 3.3 months. Baseline images showed: 6 medusa pattern (35.3%), 4 seafan pattern (23.5%) and 7 indistinct network patterns (41.2%). Mean CNV area at baseline was 1.58 +/- 1.72 mm2. Final OCTA images revealed a decrease in CNV total area of 21.6%. In 6/17 eyes the baseline neovascular pattern was unchanged; these cases were associated with exudation at the final SD-OCT examination (p=0.034) and a decrease in CNV area of 34.1 %. Conversely, in 11/17 eyes (64.7 %), the initial pattern had changed to a pruned vascular tree pattern, with variable exudative status on SD-OCT at the final visit and a decrease in total CNV area of 0.07%.
Conclusions :
Vascular flow remodeling induced by anti-VEGF treatment can be analyzed using OCTA. OCTA may help to accurately evaluate treatment response and to recognize the patterns usually associated with recurrent exudative activity.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.