Abstract
Purpose :
OCT-Angiography (OCTA) presents numerous features with uncertain clinical significance in neovascular age-related macular degeneration (NVAMD). We performed a retrospective, observational, cross-sectional, clinical study to identify potential associations between OCTA features and visual acuity (VA) in eyes treated for NVAMD.
Methods :
Study population included patients with NVAMD in one or both eyes undergoing standard of care anti-VEGF treatment with OCTA Optovue scans available (43 patients, 67 eyes). Collected OCTA features included macular neovascularization (MNV) presence, MNV location, MNV type, MNV area, MNV flow area, flow density (flow area/MNV area), central vascular trunk presence, along with OCT features of macular atrophy, intraretinal and subretinal fluid (IRF, SRF), and central subfield thickness. Patient data included VA, age, sex, smoking status, days from treatment start to OCTA scan, number of anti-VEGF injections per study eye (if known), and presence of MNV in the fellow eye. Evaluation was performed at Wisconsin Reading Center by two graders with adjudication when needed. Statistical analysis consisted of univariate and multivariate regression of logMAR VA and OCTA/patient data features.
Results :
Of the 57 gradable eyes (39 patients: mean age 78 years, 21 (60%) female), 32 (56%) had MNV visible on OCTA. MNV was at center point in 18 eyes (32%). Twenty eyes (35%) had MNV Type 1, 3 (5%) Type 2, 6 (11%) Mixed, 3 (6%) Indeterminate. There was an average MNV area of 3.41mm2, flow area of 2.04mm2, and flow density of 0.62. A central vascular trunk was present in 14 (25%), central IRF in 10 (18%), non-central IRF in 7 (12%), central SRF in 18 (32%), non-central SRF in 7 (12%), and macular atrophy in 3 (6%). Current VA negatively correlated with age (p=0.003), previous visit VA (p<0.001), MNV presence (p=0.039), and IRF presence (p<0.001) in univariate regression analysis. In multivariate analysis, VA negatively correlated with MNV presence (p=0.043), age (p=0.038), previous visit VA (p<0.001), and central IRF (p=0.012).
Conclusions :
While presence of MNV on OCTA is an important feature associated with decreased VA in treated eyes, other individual features of MNV as assessed by OCTA have uncertain significance. Further research is needed to utilize OCTA features as measurement endpoints in clinical practice and studies.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.