This study demonstrates a high level of correspondence, in patients with exudative age-related macular degeneration, between different CNV patterns identified on OCTA and treatment decisions established on conventional multimodal imaging. Although fluorescein angiography remains the gold standard for determining the presence of leakage, and OCT shows fluid accumulation and its variations, OCTA may now offer noninvasive monitoring of the CNV, aiding for each treatment decision during the follow-up.

No abstract

No abstract

OCTA allows better visualization and characterization of perifoveal microvascular changes than FA in eyes with active BU. The deep capillary plexus seemed to be more severely involved than the superficial capillary plexus.

No abstract

In a real-world setting, eyes with DME considered refractory to anti-VEGF therapy after three monthly injections which were switched to DEX implant and had better visual and anatomical outcomes at 12 months than those that continued treatment with anti-VEGF therapy.

Purpose: To report the optical coherence tomography angiography (OCT-A) findings in an exudative age-related macular degeneration (AMD) patient presenting mixed type I and II choroidal neovascularization (CNV) during follow-up after intravitreal vascular endothelial growth factor (VEGF) trap treatment. Methods: The clinical assessment included both traditional multimodal imaging, based on fluorescein angiography (FA), indocyanine green angiography (ICGA) and B-scan OCT, and OCT-A at baseline and follow-up. OCT-A images were obtained using a Spectralis OCT-A prototype able to acquire 70,000 A-scans per second, with a resolution of 7 µm axially and 14 µm laterally. An amplitude decorrelation algorithm developed by Heidelberg Engineering was applied to a volume scan, on a 15 × 5° area, which was composed of 131 B-scans (35 frames per scan) at a distance of 11 µm each. The borders of type I and type II CNV were manually outlined and then the areas were analyzed using the provided automated software before and after treatment. Results: The qualitative approach revealed a substantial decrease in the visibility of tiny branching vessels and anastomoses both in type I and type II components of the neovascular complex, associated with persistence of a clear hyperintense signal coming from the larger trunks, which remained well-perfused. Quantitative analysis confirmed a reduction of the lesion area after VEGF trap treatment: the type II component decreased from 0.25 to 0.19 mm², while the type I component decreased from 2.03 to 1.80 mm². Conclusions: Our study qualitatively and quantitatively demonstrated the response of a mixed type I-II CNV to intravitreal VEGF trap therapy. Although FA remains the gold standard for determining the presence of leakage and OCT easily shows fluid accumulation and its variations, OCT-A offers noninvasive monitoring of the retinal and choriocapillaris microvasculature in patients with CNV, aiding in diagnosis and treatment decisions during follow-up.

Our study demonstrated clinical and statistically significant differences between idiopathic PCV and NV-AMD-related polyps that could be considered as distinct entities. Although they share some similarities, mainly the sub-RPE location, the ability to identify a specific clinical pattern suggests a more specific therapeutic approach for these two entities.