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Hyungwoo Lee, Minsub Lee, Myung Ae Kim, Hyewon Chung, Hyung Chan Kim; Association of treatment response with quantitative changes in choroidal neovascularization and outer choroidal vessel in neovascular age-related macular degeneration.. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3441. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
In neovascular age-related macular degeneration (nAMD), clinical implication of quantitative parameters from optical coherence tomography angiography (OCTA) and en face optical coherence tomography (en face OCT) is still limited today.We perfromed a cross-sectional retrospective study to evaluate the association between treatment response and quantitative changes in choroidal neovascularization (CNV) and choroidal vessel using OCTA and en face OCT.
A total of 133 eyes of 129 nAMD patients treated with anti-vascular endothelial growth factor were included. Quantitative parameters including vessel area, vessel density, branch vessel length, vessel diameter, intersection number, fractal dimension (FD) and lacunarity were analyzed based on en face images of CNV and choroidal vessel in Haller’s layer. Parameters associated with loss of logMAR visual acuity (VA) over 0.3 and the CNV activity by treatment interval (good vs. poor responder) were analyzed through logistic regression analyses. These analyses were conducted for two separate periods: before OCTA (from initial visit to the day of OCTA) and after OCTA (from the day of OCTA to 6 months after OCTA).
VA loss before OCTA was associated with higher standard deviation of CNV diameter and lower choroid FD. Poor responder before OCTA was associated with lower CNV FD. VA loss after OCTA was associated with larger CNV median diameter. Poor responder after OCTA was associated with higher CNV lacunarity.
Quantitative parameters analyzed based on OCTA and en face OCT can provide information about the change in visual acuity and treatment response in nAMD patients.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
Image processing for calculating (A) CNV area (B) vessel area, (C) intersection number and branch vessel length, (D, E) vessel diameter, (F) fractal dimension and lacunarity of CNV.
Choroidal neovascularization (CNV) and choroidal vessel at Haller’s layer in eyes with visual acuity loss (VA loss) before optical coherence tomography (OCTA). (A) Increased standard deviation of CNV diameter in VA loss patient compared to the patient whose VA was not aggravated (B). (C) Decreased choroidal vessel fractal dimension in VA loss patient compared to the patient whose VA was not aggravated (D). (E, F) Skeletonized images of (C) and (D) to emphasize the lower complexity of vessel of (C) compared to (D).
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