Choroidal changes after anti-VEGF therapy to treat three different types of macular neovascularization in AMD eyes using swept-source OCT angiography

Abstract

Purpose : Choroidal changes before and after anti-vascular endothelial growth factor (VEGF) therapy were investigated in eyes with exudative age-related macular degeneration (AMD) to determine if there was a difference between eyes with macular neovascularization (MNV) that arises from the choroid (type 1 or 2) versus the retinal circulation (type 3).

Methods : Patients with treatment-naïve AMD were imaged with swept-source optical coherence tomography angiography (SS-OCTA) using a 12X12 mm scan pattern. Mean choroidal thickness (MCT) and choroidal vascularity index (CVI) were measured within 5mm and 11mm fovea-centered circles before, at the onset, and after anti-VEGF therapy.

Results : Forty-one eyes of 37 patients were included; 24 eyes with type 1 MNV, 4 eyes with type 2 MNV, and 13 eyes with type 3 MNV. Within the 5mm and 11mm circles, mean MCT and CVI measurements increased from before to the onset of exudation (all P≤0.025). MCT and CVI measurements decreased from the onset of exudation to after treatment (P<0.001). No significant changes in MCT or CVI were observed when comparing measurements before and after treatment (all P≥0.37). No significant differences in MCT or CVI measurements were observed between eyes with type 1/2 MNV and type 3 MNV.

Conclusions : The site of origin for MNV did not impact choroidal changes when measured before, at exudative onset, and after treatment, which suggests that these choroidal changes develop in response to the pro-angiogenic milieu before treatment and in response to treatment but do not depend on direct connectivity of the MNV with the choroidal circulation.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.