Vascular density in age-related macular degeneration after one year of antiVEGF treatment with treat-and-extend and fixed regimens

Resch, Miklós; Balogh, András; Deák, Gábor; Nagy, Zoltán Zsolt; Papp, András

doi:10.1371/journal.pone.0229388

Cited by 5 publications

(3 citation statements)

References 27 publications

(32 reference statements)

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“… 6 , 9 However, the choroidal vascular density appeared increased following anti-VEGF therapy, according to the selected slabs. As OCTA studies have shown that anti-VEGF agents result in decreased choroidal density, presumably due to pharmacological vasoconstriction, 10 the relative improvement in choroidal slabs on our OCTA figures may be the results of artifact or may imply a possible role of choroidal vasculature in pathology of Coats' disease patients. While the mechanism of the choroidal involvement remains unknown, we propose that studies with indocyanine green angiography may help understand if an abnormal developmental relationship exists between retinal and choroidal vasculature in Coats’ disease.…”

Section: Discussionmentioning

confidence: 78%

Optical coherence tomography angiography and multimodal imaging in the management of coats’ disease

Ashkenazy

Acón

Kalavar

et al. 2021

American Journal of Ophthalmology Case Reports

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Purpose To illustrate the spectrum of clinical and imaging features in patients with unilateral Coats’ disease at baseline and in response to treatment with laser, intravitreal bevacizumab, and regional steroids. Observations Telangiectasias, macular exudates, and vascular leakage were present in all 3 patients included in this series. After treatment with laser and bevacizumab, OCT angiography findings included an anomalous foveal vascular loop and chorioretinal anastomoses. Choroidal flow voids appeared to improve after intravitreal bevaziumab and laser treatment in 2 patients with OCT angiography obtained at follow up. A-scan axial lengths in affected eyes were 1.5–1.8 mm smaller than fellow eyes. Conclusions and importance OCT angiography is a non-invasive tool that can be a useful adjunct to multimodal imaging studies in the management of Coats’ disease. Improved vascular density following anti-VEGF injection suggests a possible role of the choroidal vasculature in this retinal vascular pathology.

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Section: Discussionmentioning

confidence: 78%

Optical coherence tomography angiography and multimodal imaging in the management of coats’ disease

Ashkenazy

Acón

Kalavar

et al. 2021

American Journal of Ophthalmology Case Reports

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“…Optical coherence tomography angiography (OCT-A) has emerged as a clinically useful tool to evaluate MNV 33 , and allows high-resolution vascular imaging and the simultaneous assessment of retinal and choroidal circulatory changes in response to anti-VEGF agents. A reduction in the vascular densities of both deep retinal and choriocapillaris plexus was seen in patients with a long-term history of ranibizumab or aflibercept therapy 19 , 21 . In these patients, increased oxygen within the inner retina due to loss of RPE and photoreceptors may cause vasoconstriction of retinal vasculature.…”

Section: Discussionmentioning

confidence: 95%

Short-term changes in retinal and choroidal relative flow volume after anti-VEGF treatment for neovascular age-related macular degeneration

Calzetti

Mora

Borrelli

et al. 2021

Sci Rep

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The effects of anti-vascular endothelial growth factor (anti-VEGF) agents on the native ocular vasculature are poorly understood. This pilot study aimed to assess short-term changes in retinal and choroidal perfusion after anti-VEGF treatment for neovascular exudative age-related macular degeneration (nAMD) using the relative flow volume (RFV) parameter derived from laser speckle flowgraphy. Ten treatment-naïve nAMD patients underwent measurements of mean, maximum, minimum, and differential RFV within a retinal arteriolar segment and a choroidal vessel segment outside the neovascular area. Measurement of retinal RFV (rRFV), choroidal RFV (cRFV), and subfoveal choroidal thickness (SCT) was repeated 9 and 35 days after a single anti-VEGF injection. The treatment caused a statistically significant decrease in the mean rRFV, mean cRFV, and SCT during the follow-up (p < 0.05). At the intermediate visit, the mean cRFV and SCT were − 17.6% and − 6.4% compared to baseline, respectively. However, at the final measurement, the mean cRFV was not different from the baseline value, which indicated waning of the anti-VEGF effect. In conclusion, a single anti-VEGF injection in treatment-naïve nAMD resulted in a decrease in retinal arteriolar and choroidal perfusion, according to the RFV parameter, which is a promising tool to simultaneously assess retinal and choroidal perfusion changes in response to anti-VEGF therapy.

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“…[8] Changes in macular vascular density have been observed in several retinal diseases and are considered an essential parameter in understanding retinal vascular health. [9,10] Given the crucial roles of GC-IPL, IPL thickness, and macular vascular density in assessing retinal health, investigating their relationship in the context of high myopia could provide valuable insights into the underlying mechanisms and potential early indicators of disease progression. Understanding the association between these two parameters may help in the early detection and monitoring of retinal changes associated with high myopia, potentially enabling targeted interventions to preserve visual function and prevent complications.…”

Section: Introductionmentioning

confidence: 99%

Quantitative Analysis of Ganglion Cell-Inner Plexiform Layer Thickness, Inner Plexiform Layer Integrity, and Macular Vascular Density in High Myopia Using Optical Coherence Tomography Angiography

Wang,

Lin,

Zhang

et al. 2024

Preprint

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Background A thinner ganglion cell-inner plexiform layer (GC-IPL) and inner plexiform layer (IPL) are indicative of several ophthalmic and central nervous system diseases. We aim to To investigate alterations in the thickness of the GC-IPL and IPL, as well as their relation to changes in macular microvasculature, in patients with high myopia. Methods Optical coherence tomography (OCT) and OCT-angiography (OCT-A) were performed on patients with high myopia (HM) and non-HM individuals. Comparative analysis was conducted to assess the thickness of the choroid, macula, GC-IPL, IPL, and macular superficial and deep vascular density (VD). Additionally, correlations between GC-IPL and IPL thickness with axial length or macular vascular density were examined. Results The results showed that HM eyes exhibited a significantly thinner subfoveal choroid and macular thickness (MT) in the 6 mm area than non-high myopia eyes (p < 0.05). In the 3 mm area, HM eyes had a lower average thickness of GC-IPL and IPL with some partial areas also showing reduced thickness (p < 0.05). Within the 6 mm area, HM eyes had significantly thinner GC-IPL and IPL overall. The ratios of GCIPL/MT and IPL/MT were smaller in HM eyes in both total and partial areas within the 6 mm area (all p < 0.05), but no difference was observed in the 3 mm area. The macular vascular density, both in the superficial and deep retinal layers, was lower in HM eyes (p < 0.05). Correlations were found between the macular vascular density and the GC-IPL and IPL within 6 mm (p < 0.005), but no linear relationship was observed between the thickness of the GC-IPL, IPL, and axial length. Conclusion High myopia eyes exhibited significant thinning of both the GC-IPL and IPL, possibly due to reduced vascular density in the retina. This thinning of the GC-IPL and IPL may indicate that neurodegenerative processes may commence prior to the development of maculopathy associated with high myopia.

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Vascular density in age-related macular degeneration after one year of antiVEGF treatment with treat-and-extend and fixed regimens

Cited by 5 publications

References 27 publications

Optical coherence tomography angiography and multimodal imaging in the management of coats’ disease

Optical coherence tomography angiography and multimodal imaging in the management of coats’ disease

Short-term changes in retinal and choroidal relative flow volume after anti-VEGF treatment for neovascular age-related macular degeneration

Quantitative Analysis of Ganglion Cell-Inner Plexiform Layer Thickness, Inner Plexiform Layer Integrity, and Macular Vascular Density in High Myopia Using Optical Coherence Tomography Angiography

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