Optical coherence tomography (OCT) angiography (OCTA) is a novel, noninvasive, three-dimensional imaging technique that allows for the visualization of intravascular flow in the microvasculature. Swept-source OCT technology utilizes longer-wavelength infrared light than conventional spectral-domain OCT. This enables improved penetration into tissue and imaging through optical opacities and is invisible to the subject. Topcon has recently developed an innovative OCTA algorithm, OCTARA (OCTA Ratio Analysis), which benefits from being paired with swept-source OCT. OCTARA aims to provide improved detection sensitivity of low blood flow and reduced motion artifacts without compromising axial resolution. In this chapter, we describe the implementation of OCTARA with swept-source OCT technology, the technical specifications of acquisition (e.g. the number of scans, area of examination field, etc.) along with the algorithm's function and principles for analysis of B-scan data to achieve angiographic visualization. Examples of OCTA scans performed using the OCTARA algorithm and a comparison of these scans with images obtained using other technologies are also presented.

Intravitreal ranibizumab and IVB are effective in the treatment of subfoveal myopic choroidal neovascularization. Intravitreal ranibizumab achieved greater efficacy than IVB in terms of the mean number of injections administered.

The simultaneous acquisition of FAF and SD-OCT provides detailed findings of retinal abnormalities of CSCR and may help to understand the evolving process linked to CSCR.

To compare the effects on visual acuity of laser treatment (LT), photodynamic therapy (PDT) with verteporfin, and intravitreal bevacizumab treatment in patients with juxtafoveal choroidal neovascularization secondary to pathologic myopia. Methods: This prospective randomized clinical investigation enrolled 54 patients, who were divided into 3 groups receiving PDT, LT, or intravitreal bevacizumab treatment. The anti-vascular endothelial growth factor group received 1.25 mg of intravitreal bevacizumab at baseline; retreatment was performed if persistent intraretinal or subretinal fluid evaluated on optical coherence tomography or if choroidal neovascularization progression was detected on fluorescein angiography. The PDT group received treatment following the Verteporfin in Photodynamic Therapy Study Group guidelines. The LT group was submitted to direct LT and received PDT treatment if subfoveal recurrence or progression was detected on fluorescein angiography. A change in best-corrected visual acuity was the primary outcome. Results: The mean best-corrected visual acuity in the PDT group decreased from 0.52 logMAR (SD, 0.24 logMAR) at baseline to 0.72 logMAR (SD, 0.25 logMAR) at the end of the study (P=.002). The LT group showed substantial stabilization from mean baseline visual acuity (mean, 0.45 logMAR [SD, 0.27 logMAR]) to the 24-month (mean, 0.56 logMAR [SD, 0.34 logMAR) examination values. The mean best-corrected visual acuity in the anti-vascular endothelial growth factor group increased from 0.6 logMAR (SD, 0.3 logMAR) at baseline to 0.42 logMAR (SD, 0.35 logMAR) at the end of the study (P =.006). Conclusions: Overall, bevacizumab treatment offers the best functional results during a 2-year follow-up. In view of the small size of the sample in this study and the relatively low frequency of juxtafoveal choroidal neovascularization secondary to pathologic myopia, a multicentric clinical trial is necessary to validate our results.

OCTA is an effective noninvasive imaging technique that can provide additional information regarding the localization and morphology of vascular lesions in all cases of NV of the optic disc and in more than half of cases of NV elsewhere, suggesting that it is a noninferior technique for the study of posterior pole alterations compared with FFA, which remains the gold standard and is fundamental for the study of the retinal periphery.