Optical Coherence Tomography Angiography Imaging of Quiescent Choroidal Neovascularization in Age-Related Macular Degeneration

Abstract

A 67-year-old asymptomatic man presented with bilateral drusen. Spectral-domain optical coherence tomography (OCT) showed no signs of choroidal neovascularization (CNV) and no intraretinal or subretinal fluid. OCT angiography (OCTA) revealed the presence of a type 1 CNV in the right eye. Management options were discussed with the patient, who opted for a clinical follow-up. This is the first description demonstrating the OCTA characteristics of a quiescent CNV secondary to age-related macular degeneration.

Comparison Between Spectral-Domain and Swept-Source Optical Coherence Tomography Angiographic Imaging of Choroidal Neovascularization

“…This ability to detect the presence and size of CNV through an intact RPE should prove particularly useful in eyes with nonexudative AMD in which CNV is present but macular fluid is absent. 10 , 19 , 20 More significantly, there is speculation that the portion of the neovascular lesion that might need to be visualized to predict future growth and exudation is the region at the borders of the lesion, and it is this border region that SS-OCTA is better at visualizing than SD-OCTA imaging. In addition, when using OCTA to follow eyes with exudative CNV to determine when retreatment might be needed, the ability to detect the entire lesion and changes at the borders of the lesion could very well influence the retreatment decision.…”

Imaging Protocols in Clinical Studies in Advanced Age-Related Macular Degeneration

“…96e99 Other investigators have noted that a nonexudative type 1 NV can be detected with OCT-A. 100,101 Optical coherence tomography angiography also enables analysis of different choroidal layers inside and at the border of atrophic lesions. 102 Because of the ability to visualize the choroid and texture of the choriocapillaris, it may be possible to use OCT-A instead of ICGA to differentiate the different types of macular atrophy.…”

Subthreshold Exudative Choroidal Neovascularization Associated With Age-Related Macular Degeneration Identified by Optical Coherence Tomography Angiography

“…OCTA also led to the discovery of previously undetectable "subclinical neovascularization" or "quiescent CNV" in nonexudative AMD patients. 10,[22][23][24][25][26] Coscas and colleagues 27 described characteristics on OCTA suggestive of quiescent CNV lesions, including long filamentous linear vessels that branch into larger mature vessels. These vessels often lack anastomoses.…”