Quantitative Optical Coherence Tomography Findings in Various Subtypes of Neovascular Age-Related Macular Degeneration

Liakopoulos, Sandra; Ongchin, Sharel; Bansal, Alok; Msutta, Sandeep; Walsh, Alexander C.; Updike, P.; Sadda, Srinivas R.

doi:10.1167/iovs.08-1877

Cited by 86 publications

(59 citation statements)

References 19 publications

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“…Various investigators have reported that SHRM occurs on fluorescein angiograms of eyes with leakage activity, 10,11 but that it may also correlate with hemorrhage, lipid, or thick fibrin. 18 Recently, various studies have described the presence of SHRM in treatment-naive n-AMD.…”

Section: Discussionmentioning

confidence: 99%

“…7 Notably, the status of the ellipsoid zone (EZ) and the external limiting membrane (ELM) has been shown to correlate with functional outcomes following anti-VEGF treatment. 8,9 One recently identified OCT feature in n-AMD is areas of altered reflectivity (low and high) that obscure normal retinal anatomical features, and these changes were first attributed to neovascular components by Liakopoulos et al 10 and Giani iovs.arvojournals.org j ISSN: 1552-5783…”

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confidence: 99%

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Changes in Neovascular Lesion Hyperreflectivity After Anti-VEGF Treatment in Age-Related Macular Degeneration: An Integrated Multimodal Imaging Analysis

Casalino

Bandello

Chakravarthy

2016

Invest. Ophthalmol. Vis. Sci.

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Citation: Casalino G, Bandello F, Chakravarthy U. Changes in neovascular lesion hyperreflectivity after anti-VEGF treatment in age-related macular degeneration: an integrated multimodal imaging analysis. Invest Ophthalmol Vis Sci. 2016;57:OCT288-OCT298. DOI:10.1167/iovs.15-18753 PURPOSE. To correlate presence of hyperreflective material (HRM) on spectral-domain optical coherence tomography (SD-OCT) with color fundus photography (CFP) in patients with different subtypes of neovascular age-related macular degeneration (n-AMD).METHODS. Retrospective assessments were made at baseline and months 1, 3, and 12 after initiation of treatment. At baseline, CFP images were graded for the presence of blood, fibrin and lipid exudates, and retinal angiograms for n-AMD subtype. At the four selected visits, SD-OCT scans were graded for HRM type (well-defined or undefined) and location (subretinal, intraretinal, and subretinal pigment epithelium [RPE]), integrity of RPE, ellipsoid zone, and external limiting membrane (ELM). RESULTS.A total of 121 eyes with active n-AMD from 117 patients were included. At baseline, undefined HRM was strongly associated with fibrin on CFP (v 2 ¼ 39.87; P < 0.001). The overall prevalence of HRM decreased from 85.9% at baseline to 52.9% by month 12. From baseline to month 12, undefined HRM decreased (53.7% vs. 7.4%, respectively) and well-defined HRM increased (32.2% vs. 45.5%, respectively). Sub-RPE HRM, which was infrequent at baseline, increased up to 30.6% by month 12. At month 12, eyes with no HRM had the best mean final best-corrected visual acuity (BCVA), and those with undefined HRM the worst. Multivariate regression analysis showed that ELM disruption at both baseline and month 12 was a negative predictive factor for final BCVA (P ¼ 0.001 and P < 0.001, respectively), whereas presence of subretinal fluid at month 12 and number of treatments were positive predictors for final BCVA (P ¼ 0.007 and P ¼ 0.041, respectively), but the covariates describing HRM did not reach statistical significance in these models. CONCLUSIONS.In eyes with n-AMD, location and morphology of HRM changed after anti-VEGF treatment, and differences were observed in the various choroidal neovascularization (CNV) subtypes. After anti-VEGF treatment, it was well-defined HRM in the sub-RPE space that was observed mostly.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Changes in Neovascular Lesion Hyperreflectivity After Anti-VEGF Treatment in Age-Related Macular Degeneration: An Integrated Multimodal Imaging Analysis

Casalino

Bandello

Chakravarthy

2016

Invest. Ophthalmol. Vis. Sci.

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“…The introduction of indocyanine green (ICG) angiography has enabled better visualization of choroidal circulation, and thus, neovascular AMD has become recognized as a broad spectrum of diseases that includes distinctive subtypes such as polypoidal choroidal vasculopathy (PCV) and retinal angiomatous proliferation (RAP). Further advancements in spectral domain optical coherence tomography (SD-OCT) has facilitated cross-sectional imaging of the retina with adequate resolution, which has consequently improved our understanding of these AMD subtypes [3-5]. Detailed imaging of the choroidal cross-section has also been recently achieved through the use of the Heidelberg Spectralis TM SD-OCT device with enhanced depth imaging (EDI) [6].…”

Section: Introductionmentioning

confidence: 99%

Subfoveal Choroidal Thickness in Eyes with Neovascular Age-Related Macular Degeneration Treated with Anti-Vascular Endothelial Growth Factor Agents

Kanadani¹,

Veloso²,

Nehemy³

2018

Ophthalmologica

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Purpose: We aimed to assess the subfoveal choroidal thickness (SFChT) and the effect of treatment with anti-vascular endothelial growth factor (anti-VEGF) agents on the SFChT in age-related macular degeneration (AMD) subtypes. Methods: We enrolled 128 eyes of 107 patients with neovascular AMD (60 women; 47 men; mean age, 73.6 ± 8.9 years), and prospectively evaluated the best-corrected visual acuity (BCVA) and SFChT at baseline and at 3, 6, and 12 months after treatment with anti-VEGF agents. Patients were assigned to the typical AMD, polypoidal choroidal vasculopathy (PCV), and retinal angiomatous proliferation (RAP) subgroups. Results: In total, 85 (66.4%), 31 (24.2%), and 12 (9.4%) eyes were assigned to the typical AMD, PCV, and RAP subgroups, respectively. The baseline mean BCVA was 0.75 ± 0.26, 0.72 ± 0.21, and 0.77 ± 0.24 logMAR in the typical AMD, PCV, and RAP subgroups, respectively (p = 0.774). The mean baseline SFChT was 203.20 ± 35.80, 271.80 ± 24.50, and 182.93 ± 31.31 µm, respectively (p < 0.001). Mean SFChT significantly decreased from baseline to 3, 6, and 12 months after treatment. The RAP subtype presented a significantly higher decrease in SFChT compared to the other subtypes (p = 0.01). The percentage reduction in SFChT was not significantly correlated with the number of injections (r = –0.02; p = 0.823). No association was observed between baseline SFChT and final visual acuity at 12 months (r = 0.0; p = 0.586). Conclusions: SFChT was greatest in eyes with PCV and least in eyes with RAP. The reduction in SFChT after treatment was greater in the RAP cases. The decrease in SFChT after 12 months of anti-VEGF treatment was not associated with the number of injections and there was no correlation between the baseline SFChT and visual acuity in all AMD subtypes.

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“…We speculate that a sort of RPE hyperplasia subsequent to mCNV formation is very likely to explain the shape and morphology of mCNV that can resemble occult CNV, in which most of the RPE layer is intact and does not permit the growth of new vessels toward the neuroretina [6]. Moreover, most of the lesion complex was confined close to or within the RPE layer.…”

Section: Discussionmentioning

confidence: 99%

“…The tomographic aspects of choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) have been amply described [5,6], but mCNV has been studied less by SD-OCT, although these forms are among the main causes of vision loss in developed countries, estimated to occur in 5-10% of patients with high myopia [7,8,9,10]. …”

Section: Introductionmentioning

confidence: 99%

Imaging of Naive Myopic Choroidal Neovascularization by Spectral-Domain Optical Coherence Tomography

Milani

Pece²,

Pierro

et al. 2014

Ophthalmologica

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Purpose: To assess the tomographic features of myopic choroidal neovascularization by spectral-domain optical coherence tomography. Methods: We consecutively reviewed the charts of patients with pathologic myopia, recent visual acuity deterioration and active macular neovascularization. Specific tomographic changes were studied in 25 eyes by two authors independently. Results: The mean age of patients eligible for the study was 63.4 (±18.2) years. Main tomographic outcomes were the hyperreflectivity of the lesion in 88% of cases (95% CI 0.74-1.02), absence of the external limiting membrane in 88% (95% CI 0.84-1.02), and retinal thickening in 83% (95% CI 0.67-0.99). The internal plexiform layer remained discernible in 83% (95% CI 0.67-0.99) of cases, the inner nuclear layer in 62% (95% CI 0.37-0.80), the external plexiform layer in 48% (95% CI 0.27-0.69). Retinal edema was noted in 48% (95% CI 0.26-0.70) of patients. Conclusions: Myopic choroidal neovascularization appears predominantly hyperreflective, causes thickening of the corresponding retina and mainly involves the external retinal segments. Retinal fluid is infrequent.

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Quantitative Optical Coherence Tomography Findings in Various Subtypes of Neovascular Age-Related Macular Degeneration

Abstract: OCT and angiography provide complementary information regarding CNV lesions. Quantitative analysis of OCT images allows for an improved understanding of the anatomic characteristics of angiographically defined CNV lesion subtypes.

Cited by 86 publications

References 19 publications

Changes in Neovascular Lesion Hyperreflectivity After Anti-VEGF Treatment in Age-Related Macular Degeneration: An Integrated Multimodal Imaging Analysis

Changes in Neovascular Lesion Hyperreflectivity After Anti-VEGF Treatment in Age-Related Macular Degeneration: An Integrated Multimodal Imaging Analysis

Subfoveal Choroidal Thickness in Eyes with Neovascular Age-Related Macular Degeneration Treated with Anti-Vascular Endothelial Growth Factor Agents

Imaging of Naive Myopic Choroidal Neovascularization by Spectral-Domain Optical Coherence Tomography

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