Detection of Nonexudative Choroidal Neovascularization and Progression to Exudative Choroidal Neovascularization Using OCT Angiography

Bailey, Steven T.; Thaware, Omkar C; Wang, Jie; Hagag, Ahmed M; Zhang, Xinbo; Flaxel, Christina J.; Lauer, Andreas K.; Hwang, Thomas S.; Lin, Phoebe; Huang, David; Jia, Yali

doi:10.1016/j.oret.2019.03.008

Cited by 56 publications

(38 citation statements)

References 34 publications

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“…Exudative MNV may progress and grow at a more rapid rate than nonexudative MNV. 46 Also, the perilesional DH may be identified more commonly in eyes with exudative MNV, 18 , 45 because active neovascularization may steal adjacent blood flow from surrounding capillaries. In the present study, eyes with exudative MNV showed a larger mean DH area and greater surrounding CC FD than eyes with nonexudative MNV, although these results were not statistically significant.…”

Section: Discussionmentioning

confidence: 99%

Choriocapillaris Flow Deficits and Treatment-Naïve Macular Neovascularization Secondary to Age-Related Macular Degeneration

Scharf

Corradetti

Alagorie

et al. 2020

Invest. Ophthalmol. Vis. Sci.

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Purpose To evaluate choriocapillaris (CC) flow deficits (FD) in eyes with treatment-naïve macular neovascularization (MNV) and to compare CC FD around exudative versus nonexudative MNV. Methods Treatment-naïve eyes with a diagnosis of either exudative or nonexudative AMD and type 1 MNV were included. Normal control eyes were age-matched to each AMD eye one to one. En face optical coherence tomography angiograms were analyzed for percentage of CC FD (FD%) in two concentric 500 µm rings, ring 1 and ring 2, surrounding the dark halo around MNV. The mean CC FD% in ring 1 and ring 2 was evaluated for each eye. A secondary analysis was similarly carried out to investigate the differences in CC FD% in exudative versus nonexudative treatment-naïve MNV. Results Twenty-three eyes with treatment-naïve MNV were age matched with 23 normal controls. The mean CC FD% was significantly greater in both rings in the MNV versus the normal control group ( P < 0.05) and was significantly greater in the inner ring, closer to the lesion, than the outer ring. The mean FD% was also greater in both rings in the exudative versus the nonexudative MNV group, but this difference did not reach statistical significance. Conclusions The CC FD% was greater in the area surrounding MNV versus age-matched normal controls and in the ring closer to the MNV lesion. Further, CC FD was greater in eyes with exudative versus nonexudative MNV in both rings surrounding the associated dark halo, although this difference was not statistically significant.

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Section: Discussionmentioning

confidence: 99%

Choriocapillaris Flow Deficits and Treatment-Naïve Macular Neovascularization Secondary to Age-Related Macular Degeneration

Scharf

Corradetti

Alagorie

et al. 2020

Invest. Ophthalmol. Vis. Sci.

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“…In contrast, Xu et al 27 described a general increase in the size of CNV under anti-VEGF therapy, and Carnevali et al 28 observed a growth in size of quiescent CNV without correlation to clinical activity. Bailey et al 29 found, in eyes with non-exudative CNV, a CNV area growth rate of 20% per month associated with a high risk to develop exudation. Therefore size change of aCNV could be one important parameter for assessment of CNV activity.…”

Section: Discussionmentioning

confidence: 99%

Changes in the OCT angiographic appearance of type 1 and type 2 CNV in exudative AMD during anti-VEGF treatment

et al. 2019

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ObjectiveOptical coherence tomography angiography (OCT-A) enables detailed visualisation of the vascular structure of choroidal neovascularisation (CNV). The aim of this study was to determine whether mathematically ascertained OCT-A vascular parameters of type 1 and type 2 CNV in exudative age-related macular degeneration (AMD) change during antivascular endothelial growth factor (anti-VEGF) treatment. The OCT-A vascular parameters were also compared with previously obtained activity parameters (fluid distribution on spectral domain OCT (SD-OCT)) to establish whether they could potentially be used as further ‘activity parameters’ for assessment of anti-VEGF treatment.Methods and AnalysisWe evaluated 27 eyes of 27 patients (mean follow-up 9.8 months) with type 1, type 2 or mixed CNV who had received anti-VEGF treatment (IVAN scheme). The parameters analysed were area (aCNV), total length of all vessels (tlCNV), overall number of vascular segments (nsCNV) and fractal dimension (FD) of the CNV. The changes in each of these parameters were correlated with the central foveal thickness (CFT).ResultsRegression and renewed perfusion of the CNV corresponded with the decrease or increase, respectively, of macular fluid distribution on SD-OCT. The increase and decrease of CFT during anti-VEGF treatment were highly significantly correlated with changes in FD (p<0.00001), aCNV (p<0.00001), tlCNV (p<0.00001) and nsCNV (p<0.00001).ConclusionOCT-A enables detailed analysis of AMD with regard to FD, aCNV, tlCNV and nsCNV. As the changes in these parameters correlate closely with changes on SD-OCT, they can be used as new activity parameters, alongside fluid distribution, for assessment of treatment effect and as parameters of stabilisation or the need for repeated treatment.

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“…De Oliveira Dias et al and Yang et al found a cumulative incidence of exudation of 24% after 1 year and of 34.5% after 2 years of follow-up in eyes with iAMD [13,14], whereas Heiferman et al described an incidence of exudation of 20% after 15 months of follow up in patients with active neovascular AMD in the contralateral eye [116]. Different results were obtained by Bailey et al, who found an incidence of exudation of 80% at 2 years [15]. These differences could be explained by several factors including different populations, the number of patients evaluated, and the duration of AMD.…”

Section: Octa In Nonexudative Mnv In Amdmentioning

confidence: 93%

“…The prevalence of nonexudative MNV was evaluated with OCTA by different groups, particularly in the contralateral eyes of patients with unilateral exudative AMD [13][14][15]. De Oliveira Dias et al [13] and Yang et al [14] reported a prevalence of 14.4% and 13.2% respectively at baseline of eyes with iAMD and GA, while Bailey et al [15] found a prevalence of 7.9%. Capuano et al analyzed 644 eyes from 399 consecutive patients with unilateral or bilateral GA secondary to AMD and identified 73 eyes from 71 patients (11%) with nonexudative MNV [110].…”

Section: Octa In Nonexudative Mnv In Amdmentioning

confidence: 99%

“…The Consensus on Neovascular AMD Nomenclature (CONAN) group stated that this form of MNV could be identified more commonly with the improvement of imaging technology, but there is still not a consensus on which term to use [9]. In this article, we will use the term nonexudative MNV, even if there is a substantial difference between the term "treatment-naïve quiescent neovascularization" used by Querques and colleagues [10] and "asymptomatic, nonexudative or subclinical MNV" used by other authors [12][13][14][15]. Treatment-naïve quiescent neovascularization are MNVs without sign of activity for at least 6 months from baseline, while all the other terms refer to new diagnosis MNVs without exudation [10,[12][13][14][15]].…”

Section: Introductionmentioning

confidence: 99%

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Optical Coherence Tomography Angiography in Intermediate and Late Age-Related Macular Degeneration: Review of Current Technical Aspects and Applications

et al. 2020

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Optical coherence tomography angiography (OCTA) is a non-invasive diagnostic instrument that has become indispensable for the management of age-related macular degeneration (AMD). OCTA allows quickly visualizing retinal and choroidal microvasculature, and in the last years, its use has increased in clinical practice as well as for research into the pathophysiology of AMD. This review provides a discussion of new technology and application of OCTA in intermediate and late AMD.

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Detection of Nonexudative Choroidal Neovascularization and Progression to Exudative Choroidal Neovascularization Using OCT Angiography

Cited by 56 publications

References 34 publications

Choriocapillaris Flow Deficits and Treatment-Naïve Macular Neovascularization Secondary to Age-Related Macular Degeneration

Choriocapillaris Flow Deficits and Treatment-Naïve Macular Neovascularization Secondary to Age-Related Macular Degeneration

Changes in the OCT angiographic appearance of type 1 and type 2 CNV in exudative AMD during anti-VEGF treatment

Optical Coherence Tomography Angiography in Intermediate and Late Age-Related Macular Degeneration: Review of Current Technical Aspects and Applications

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