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David Sarraf, Adrian Au, Kirk Kohwa Hou, Juan Pablo Davila, Frederic Gunnemann, Serena Fragiotta, Riccardo Sacconi, Malvika Arya, Daniel Pauleikhoff, Giuseppe Querques, Nadia K Waheed, K Bailey Freund, Srinivas R Sadda; 3D Volumetric Analysis of Vascularized Serous Pigment Epithelial Detachment Progression in Neovascular AMD using OCT Angiography. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2999. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze the evolution of type 1 neovascularization associated with vascularized serous pigment epithelial detachment (vsPED) using three-dimensional, volumetric, en-face optical coherence tomography angiography (OCTA)
Retrospective case series from four tertiary medical centers. OCTA images were analyzed at baseline, 3-, 6-, 12-, 18-, and 24-month follow-up when available. Visual acuity, interval injection history, PED maximal height and volume, and choroidal neovascularization (CNV) flow area and progression were determined at each visit. Qualitative and quantitative analysis of CNV progression and final PED morphology was performed to determine anatomical outcomes.
Twenty-four eyes in twenty-two patients from four tertiary medical centers were studied. Average follow-up was 17.6 months. Across all eyes, maximum PED height decreased from 373.1μm to 317.7μm while flow area increased from 25.4% to 36.7%. Visual acuity worsened from 20/44 to 20/63. Final PED outcomes included filled fibrovascular versus persistent vascularized serous PED. Filled vsPEDs collapsed, decreased in PED height and volume, and displayed a multilayered morphology in contrast to persistent vsPEDs. Fibrovascular mulitlayered PEDs required on average seven less injections as compared to persistent vsPEDs.
Three dimensional, volumetric, en-face OCTA analysis of vsPED progression illustrated two anatomical outcomes: a filled, collapsed, typically multilayered fibrovascular PED versus a persistent vsPED. The filled multilayered PED displayed a reduction in PED height and volume, greater CNV flow area, and lower anti-VEGF injection burden versus the persistent vsPED and may represent a more stable anatomical outcome while the persistent vs PED may indicate a more unstable morphology.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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