Purchase this article with an account.
Rami San Gabriel, Chirag Shah, Jaime Toledo Corral, Mitul C Mehta; Quantitative Optical Coherence Tomography Angiography of Dry vs Wet AMD and the Effects of Prolonged Anti-VEGF Therapy. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3007.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To investigate the structural integrity of the superficial capillary plexuses (SCPs) and deep capillary plexuses (DCPs) using optical coherence tomography angiography (OCTA) in patients with wet and dry Age-Related Macular Degeneration (AMD) and its association with the response to multiple exposures to anti-vascular endothelial growth factor (VEGF) treatment.
The medical records, including OCTA and patient variables, were reviewed and compared between the groups. A total of 2769 3mm×3mm OCTA scans from 951 patients (1827 eyes) were reviewed and 41 scans from 35 wet AMD patients and 47 scans from 31 dry AMD patients met exclusion criteria (signal strength, no geographic atrophy, non-repeat, etc). En face OCTA images of the SCP, DCP, and foveal avascular zone (FAZ) were obtained for each eye and quantitative values were extracted and compared using an unpaired t-test. Impacts of Anti-VEGF treatment on quantitative OCTA values were evaluated using Pearson Correlation and linear regression.
Compared with dry AMD eyes, wet AMD eyes had a significantly enlarged FAZ area (P=0.0106) with a Mean ± SD of 0.262 ± 0.021 mm^2 and 0.341 ± 0.022 mm<span style="font-size:10.8333px">^2</span>, respectively. The superficial and deep plexus did not show a significant difference between the two groups. Linear regression of the foveal SCP and DCP showed a rarefaction of capillaries with increasing lifetime number of Anti-VEGF injections (P=0.0223 and P=0.0041). The FAZ also increased in area in correlation with increased total lifetime injections of Anti-VEGF (P=0.0146).
The wet AMD group that received injections had an increased FAZ when compared to dry AMD patients. Moreover, the total amount of Anti-VEGF injections received correlated with damage to the integrity of the foveal SCP and DCP. Subjects who had more lifetime injections with Anti-VEGF were more likely to have decreased capillary densities and increased FAZ. The extent of damage to capillary structures monitored by OCTA could allow monitoring of progression towards geographic atrophy(GA) which has recently been described in the literature to have capillary damage surrounding the GA margin.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
Figure 1. Graphical representation of FAZ in Dry and Wet AMD subgroups. Results are of an unpaired t-test.
Figure 2. Linear regression of FAZ in comparison to the total number of injections received by a subject.
This PDF is available to Subscribers Only