Characterization of Idiopathic Choroidal Neovascularization Using Fluorescein Angiography, Indocyanine Green Angiography, and Optical Coherence Tomography Angiography

Kumar, Ajeet; Vohra, Rajpal; Agrawal, Surbhi; Chawla, Rohan; Azad, Shorya Vardhan; Venkatesh, Pradeep; Sharma, Anu

doi:10.3928/23258160-20180628-08

Cited by 4 publications

(5 citation statements)

References 11 publications

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“…Follow up OCTA after 4 weeks revealed marked resolution (network of individual vessels not identifiable with >50% reduction in size of visible membrane; grading of resolution proposed by authors. 3 Patient maintained visual acuity with resolution of subjective symptoms.…”

Section: Case Series 1 -'Simplifying Diagnosis'mentioning

confidence: 88%

OCT Angiography – A Perspective Based on 3 Years of Clinical Application

Agrawal¹,

Chawla²,

Sundar³

et al. 2019

DJO

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Optical Coherence Tomography Angiography is a new technique for non-invasive, dyeless angiography. It gives flow information of retinal and choroidal vasculature. It's utility in diagnosing and monitoring various retino-choroidal vascular pathologies especially CNV (choroidal neovascular membranes) has been well established in a number of studies. A few clinical cases are discussed herein which highlight different aspects of OCT-A guided clinical management. It is of importance to understand the imaging characteristics and artifacts on OCT-A before adopting it as the primary angiographic modality. As always clinical correlation with history and other imaging modalities like OCT must be done before deciding 'which vessels to treat'.

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Section: Case Series 1 -'Simplifying Diagnosis'mentioning

confidence: 88%

OCT Angiography – A Perspective Based on 3 Years of Clinical Application

Agrawal¹,

Chawla²,

Sundar³

et al. 2019

DJO

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“…It has been observed that the OCT-angiographic appearance of iCNV networks is different from neovascular AMD membranes. The neovascular network in iCNV is usually composed of well-defined compact lesions with internal anastomosing capillaries,[ 9 15 ] whereas in AMD-associated CNV, the network is identified as a central feeder trunk with vessels radiating out in a branching pattern. [ 16 ] The difference could also be ascribed to the fact that AMD is more commonly associated with type 1 CNV,[ 17 ] whereas all our cases were type 2 CNV.…”

Section: Discussionmentioning

confidence: 99%

“…Arborizing morphology was identified as multiple dendritic, branching vessels, not limited within the perimeter of the network [ Figure 1 ]. [ 9 ] To minimize errors occurring due to automated segmentation of OCT-A, manual segmentation of all OCT-A acquisitions was done. The segmentation level of follow-up imaging was matched to the pretreatment images.…”

Section: Methodsmentioning

confidence: 99%

“…Response on OCT-A was graded as “Marked” if the network of individual vessels is not identifiable (highly fragmented) at follow-up with a visually significant reduction in size of the CNV (>50% reduction) on OCT-A, “Moderate” if the network of vessels is still identifiable, but there is a visually significant reduction in size of the CNV (>50% reduction) on OCT-A, and “Mild” if the network of vessels is almost same with no or minimal reduction (<50% reduction) in size of the CNV on OCT-A [ Figure 1 ]. [ 9 ] A possible novel biomarker was observed by the authors after analyzing the pre- and posttreatment OCT images of all patients. The biomarker involved the presence of a hyper-reflective membrane continuous with RPE that appeared to partially or fully cover the subretinal hyper-reflective material [SRHM; Figure 2 ].…”

Section: Methodsmentioning

confidence: 99%

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Imaging-based Biomarkers as Predictors of Response to Anti-VEGF Therapy in Idiopathic Choroidal Neovascularization

Agrawal,

Chawla,

Todi

et al. 2023

Middle East African Journal of Ophthalmology

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PURPOSE: The purpose of this study was to identify biomarkers that predict the response of treatment-naive idiopathic choroidal neovascularization (iCNV) to anti-VEGF treatment. METHODS: Fourteen eyes diagnosed with iCNV underwent a dilated fundus examination, Swept Source Optical Coherence Tomography (SS-OCT) and Optical Coherence Tomography - Angiography (OCT-A), and were given an anti-VEGF injection. The same examinations were repeated at every follow-up visit. Analysis of the pre- and posttreatment images was done to identify possible biomarkers which were evaluated to check association with decreased need for multiple anti-VEGF injections. RESULTS: At presentation, 11 patients showed a compact pattern, while three patients showed an arborizing pattern on OCT angiography (P = 1). On follow-up imaging, seven patients showed a marked response, five patients showed a moderate response, and two patients showed a mild response to anti-VEGF injection. Among the seven patients showing a marked response, only one required a repeat injection (P = 0.03). On analysis of SS-OCT, a novel Retinal Pigment Epithelium (RPE) healing response was observed in posttreatment imaging of six patients (P = 0.59). CONCLUSION: A ”marked” response to the first anti-VEGF injection results in a more sustained response and is a positive prognostic factor. RPE healing response is an interesting observation that merits further evaluation. Morphology of neovascular membranes has no effect on long-term need for multiple anti-VEGF injections.

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“…In the early stage of CNV, there are usually no conscious symptoms ( Aggarwal et al, 2019 ). With the development of the disease, it can cause visual impairment, visual distortion or central dark spot ( Kumar et al, 2018 ). In general fundus examination, the manifestation is subretinal hemorrhage and lipid-like exudation.…”

Section: Introductionmentioning

confidence: 99%

Establishing a mouse model of choroidal neovascularization to study the therapeutic effect of levotinib and its mechanism

Xin

Zhu

et al. 2020

Saudi Journal of Biological Sciences

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Objective To study the therapeutic effect and mechanism of levotinib on choroidal neovascularization (CNV) in mice. Methods 45 healthy C57BL/6 mice were selected and randomly divided into three groups: control group (group A), model group (group B) and levotinib group (group C). The model of CNV in mice was established. The fluorescence leakage of choroidal lesions in mice was observed by fundus fluorescein angiography. The morphological changes of retinal vessels in mice were observed by retinal slice preparation, the pathological changes of eyeball tissues in mice were observed by hematoxylin-eosin (HE) staining, the expression of vascular endothelial growth factor (VEGF) in mice retina was detected by real-time quantitative fluorescence PCR, and the protein expression of VEGF in mice retina was detected by Western blotting. Result On the 7th, 14th and 21st day after modeling, compared with group B, the fluorescence leakage area of group C mice was significantly reduced, and the difference was statistically significant (P < 0.05). The morphology of retinal vessels in group A was normal. In group B, the retinal vessels showed large areas of ischemia without perfusion and abundant neovascularization clusters and capillaries. Compared with group B, the morphology of retinal vessels in group C was significantly improved. Group A mice had normal eyeball structure, group B mice had visible spindle-like damage to the inner and outer retina, while group C mice had significantly less spindle-like damage than group B. Compared with group A, group B mice had significantly higher expression of retinal VEGF and the difference was statistically significant (P < 0.05), but compared with group B mice, the expression of VEGF in the retina of mice in group C was significantly decreased, and the difference was statistically significant (P < 0.05). Compared with group A, the expression of VEGF in retina of group B mice was significantly increased, and the difference was statistically significant (P < 0.05). Compared with group B, the expression of VEGF in retina of group C mice was significantly decreased, and the difference was statistically significant (P < 0.05). Conclusion Levatinib has obvious therapeutic effect on CNV, which may be achieved by inhibiting the high expression of VEGF in CNV.

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Characterization of Idiopathic Choroidal Neovascularization Using Fluorescein Angiography, Indocyanine Green Angiography, and Optical Coherence Tomography Angiography

Abstract: OCTA is a useful, noninvasive tool to detect, characterize, and follow-up on cases of suspected iCNV with utility comparable to or even better than traditional angiography techniques. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:516-522.].

Cited by 4 publications

References 11 publications

OCT Angiography – A Perspective Based on 3 Years of Clinical Application

OCT Angiography – A Perspective Based on 3 Years of Clinical Application

Imaging-based Biomarkers as Predictors of Response to Anti-VEGF Therapy in Idiopathic Choroidal Neovascularization

Establishing a mouse model of choroidal neovascularization to study the therapeutic effect of levotinib and its mechanism

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