Macular Atrophy Findings by Optical Coherence Tomography Angiography Compared With Fundus Autofluorescence in Treated Exudative Age-Related Macular Degeneration

Takasago, Yukari; Shiragami, Chieko; Kobayashi, Mamoru; Osaka, Rie; Ono, Aoi; Yamashita, Ayana; Tsujikawa, Akitaka; Hirooka, Kazuyuki

doi:10.1097/iae.0000000000001980

Cited by 5 publications

(4 citation statements)

References 24 publications

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“…The commercially available OCTA systems include SSADA algorithm based AngioVue system (Optovue, Inc., Fremont, CA, USA), 89 OMAG algorithm based AngioPlex system (Carl Zeiss Meditec Inc., Dublin, CA, USA) spectral domain OCTA,202 amplitude decorrelation algorithm based sweptsource optical coherence tomography Angio (Topcon Corp., Japan),231 and OCTA ratio analysis algorithm based Heidelberg Spectralis OCTA (Heidelberg, Germany) 227. OCTA has potential applications in evaluation and management of various eye diseases like age related macular degeneration,201,237,32 diabetic retinopathy,136,92 diabetic macular edema, 40 choroidal neovascularization, 39 retinal vascular occlusion,…”

mentioning

confidence: 99%

Assessment of flow dynamics in retinal and choroidal microcirculation

Wei

Balne

Meissner

et al. 2018

Survey of Ophthalmology

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Alterations in ocular blood flow have been implicated in mechanisms that lead to vision loss in patients with various ocular disorders such as diabetic retinopathy, glaucoma, and age-related macular degeneration. Assessment of retinal and choroidal blood flow is also a window to evaluate systemic diseases that affect microvasculature. Quantification and qualification of the blood flow in the retina and choroid help us understand pathophysiology, stratify disease risk, and monitor disease progression in these disorders. Multiple methods are used by researchers for assessment of blood flow, but a gold standard is lacking. We review commonly used methods, both invasive and noninvasive, for evaluation of blood flow, including intravital microscopy, laser Doppler velocimetry, laser Doppler flowmetry, laser interferometry, confocal scanning laser Doppler flowmetry, laser speckle flowgraphy, Doppler optical coherence tomography, blue-field entoptic simulation, retinal vessel caliber assessment, optical coherence tomography angiography, retinal function imaging, color Doppler imaging, and scanning laser ophthalmoscope angiogram. As technology evolves, better evaluation of blood flow in various ocular and systemic diseases will likely bring new perspectives into clinical practice and translate to better diagnosis and treatment.

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mentioning

confidence: 99%

Assessment of flow dynamics in retinal and choroidal microcirculation

Wei

Balne

Meissner

et al. 2018

Survey of Ophthalmology

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“…OCT angiography studies have shown choriocapillaris nonperfusion in both GA and macular atrophy. 25, 26 Nonperfusion is more extensive in macular atrophy compared to GA and extends outside the areas of visible atrophy. The addition of the neovascular process to an already damaged RPE and choroidal vasculature could potentially result in worsening of the disease.…”

Section: Discussionmentioning

confidence: 99%

“…However, the development of neovascular AMD in eyes with GA is a known entity with incidence in the Beaver Dam Eye study at 10.9% and the Blue Mountain Eye Study at 22% over 5 years. 26, 27 Recent advanced imaging studies using OCT angiography have, in fact, shown unsuspected quiescent neovascularization adjacent to areas of GA. 28, 29 Conversely, the development of GA in eyes with neovascular AMD has been rarely studied before anti-VEGF therapy as we were unable to identify atrophy in the presence of fibrosis, pigment and photocoagulation scars. It may be that the development of atrophy is the final common pathway of AMD, with the neovascular process intercepting the pathway in some eyes.…”

Section: Discussionmentioning

confidence: 99%

Atrophy in Neovascular Age-Related Macular Degeneration

Domalpally

Danis

Trane

et al. 2018

Ophthalmology Retina

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Purpose To identify the development and progression of macular retinal pigment epithelial atrophy in eyes with neovascular (CNV) age-related macular degeneration (AMD) and to correlate with visual acuity (VA) Design Cohort study Participants Age-Related Eye Disease Study 2 (AREDS2) participants with intermediate AMD enrolled in a randomized controlled clinical trial of oral supplements. Analyses were conducted in the subset of AREDS2 participants who were also enrolled in the fundus autofluorescence ancillary (FAF) ancillary study. Methods Color photographs and FAF images were evaluated in eyes that developed CNV. Presence of geographic atrophy (GA) prior to the incidence of CNV and the development of macular atrophy following incident CNV were assessed. Areas of hypoautofluorescence representing atrophy were measured for area and macular involvement. Enlargement rate of atrophy and change in visual acuity over time were analyzed. Main Outcome Measures incidence and enlargement rate of atrophy and VA changes in eyes with incident CNV Results Incident CNV developed in 334 (9.2%) of eyes evaluated in the AREDS2 FAF substudy. Of these, 40% had macular atrophy at incidence of CNV with half of these attributable to pre-existing GA. Atrophy developed in 14.7 % of eyes over 4 years of follow-up. Mean area of atrophy was largest in eyes with pre-existing GA and CNV (5.17 mm2, p<0.001), and atrophy involved the center of the macula in > 65% of eyes. Mean VA letter score at the annual visit in which CNV was documented was similar in the three groups with atrophy; eyes with CNV and pre-existing GA, incident atrophy at the first visit with CNV, and atrophy during follow up (60 letters). Enlargement rate of atrophy was also similar in eyes in the three groups (1.23 – 1.86 mm2, p = 0.47). Eyes with macular atrophy lost more visual acuity compared to eyes without atrophy, particularly after 2 years of follow-up (−10.9 vs. – 3.6 letters, p = 0.07). Conclusion Atrophy is commonly seen in neovascular AMD and often can be attributed to pre-existing GA. Macular atrophy and GA appear to be a continuum of the same disease process and are both associated with poor vision.

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“…Takasago et al found that the choriocapillaris (CC) nonperfusion area and MA area were significantly correlated as these areas markedly overlapped. They concluded that choroidal ischaemia might be thus involved in the pathogenesis of MA in treated nAMD, and that CC nonperfusion after anti-VEGF might be associated with the development of MA [72]. Mastropasqua et al reported intravitreal administration of aflibercept to be associated with a significant reduction of flow in both native retinal and choroidal vasculature in patients' treated eyes [73].…”

Section: Subfoveal Choroidal Thicknessmentioning

confidence: 99%

A Review of Macular Atrophy of the Retinal Pigment Epithelium in Patients with Neovascular Age-Related Macular Degeneration: What is the Link? Part II

2020

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Introduction: To explore the potential link between macular atrophy (MA) of the retinal pigment epithelium (RPE) in patients with neovascular age-related macular degeneration (nAMD) and anti-vascular endothelial growth factor (anti-VEGF) treatment. Methods: Through a balanced overview of the field from a largely clinical perspective, we looked at available evidence on the topic of MA correlation with anti-VEGF therapy and examined possible risk factors for MA development in the context of nAMD treatment with anti-VEGF. Results: Links have been reported to connect both MA incidence and progression to treatment frequency and to the anti-VEGF drug type. Conclusions: All reports agree on the fact that de novo development of MA in anti-VEGFtreated eyes is frequent and multifactorial. Research data shows an expansion of atrophy during anti-VEGF treatment. There are mixed conclusions about the correlation of MA incidence or progression with treatment-related risk factors. It mostly appears that there is no straightforward link. More clinical research is still needed to further understand this association.

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Macular Atrophy Findings by Optical Coherence Tomography Angiography Compared With Fundus Autofluorescence in Treated Exudative Age-Related Macular Degeneration

Cited by 5 publications

References 24 publications

Assessment of flow dynamics in retinal and choroidal microcirculation

Assessment of flow dynamics in retinal and choroidal microcirculation

Atrophy in Neovascular Age-Related Macular Degeneration

A Review of Macular Atrophy of the Retinal Pigment Epithelium in Patients with Neovascular Age-Related Macular Degeneration: What is the Link? Part II

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