June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
OCT angiography to assess outcomes of type 1 macular neovascularization in eyes with treatment naïve exudative AMD
Author Affiliations & Notes
  • swathi somisetty
    Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California, United States
  • Elodie Bousquet
    Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California, United States
    Department of Ophthalmology, Ophtalmopôle, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP, Université Paris 5, Sorbonne Paris Cité, Paris, France
  • Ahmad Santina
    Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California, United States
  • Veronica Romero Morales
    Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California, United States
    Instituto Mexicano de Oftalmologia I.A.P., Mexico
  • Neda Abraham
    Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California, United States
  • David Sarraf
    Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California, United States
    Greater Los Angeles VA Healthcare Center, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   swathi somisetty None; Elodie Bousquet None; Ahmad Santina None; Veronica Romero Morales None; Neda Abraham None; David Sarraf Heidelberg, Code F (Financial Support), Optovue, Code F (Financial Support)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 1343 – F0177. doi:
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      swathi somisetty, Elodie Bousquet, Ahmad Santina, Veronica Romero Morales, Neda Abraham, David Sarraf; OCT angiography to assess outcomes of type 1 macular neovascularization in eyes with treatment naïve exudative AMD. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1343 – F0177.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : OCT angiography is a very important tool to detect macular neovascularization (MNV) but its value would be further strengthened by providing prognostic information. The aim of this study was to evaluate the outcomes of eyes with treatment naïve exudative age-related macular degeneration (AMD) based on baseline OCT angiography (OCT-A) morphology of type 1 MNV.

Methods : This was a retrospective study of treatment naïve AMD patients that developed exudative disease. MNV was classified as “distinct” or “indistinct/absent” in each patient at baseline with OCT-A and the kappa coefficient was calculated. Clinical and imaging data were reviewed at baseline and after 12 months of anti-VEGF therapy. Markers such as best-corrected visual acuity (BCVA), central macular thickness (CMT), subretinal fluid (SRF), intraretinal fluid (IRF), subretinal hyper-reflective material (SHRM), and retinal pigment epithelial (RPE) atrophy were evaluated using spectral-domain OCT.

Results : Twenty-six eyes of 26 patients were included in this study. Seven eyes displayed “distinct” MNV and 19 eyes displayed “indistinct” MNV. Kappa coefficient for classifying MNV among the graders was calculated to be 76% (p<0.05).

At baseline, there was no statistically significant difference in age, gender, and BCVA between both groups. The central macular thickness was lower in patients with distinct MNV (218 ± 68.7 vs 314.2 ± 48; p=0.002). RPE atrophy was more prevalent in the distinct MNV group (71.4% vs 15.8%; p=0.014). There was no statistically significant difference in percentage of subretinal fluid, intraretinal fluid, and SHRM between both groups at baseline.

One year after anti-VEGF therapy, signs of persistent exudation (SRF, IRF, or SHRM) were detected in 5 eyes (71.3%) in the distinct MNV group and 6 eyes (31.6%) in the indistinct MNV group (p=0.09). The number of anti-VEGF injections between both groups was not different (6.9± 3.1 vs 7.8± 3.1; p=0.69).

Conclusions : This study suggests that AMD patients with distinct type 1 MNV on OCT-A at baseline have greater central macular thinning and RPE atrophy compared to those with indistinct MNV. The distinct MNV group may be less responsive to anti-VEGF therapy after 1 year. Further studies with a larger sample size are mandatory to confirm these results.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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