Analysis and follow-up of type 1 choroidal neovascularisation with optical coherence tomography–angiography after antiangiogenic treatment

Torrecillas-Picazo, R.; Cerdà-Ibáñez, M.; Palacios, I. Almor; Hernandis, J.M. Hervás; Ramón-Cosín, R.; Río, N. Ruiz del; Duch-Samper, A.

doi:10.1016/j.oftale.2017.02.010

Cited by 4 publications

(2 citation statements)

References 20 publications

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“…The correlation between the increase and decrease of aCNV and the increase and decrease of CFT, together with the significantly smaller area in the inactive phase of disease, shows that OCT-A achieves more precise analysis of the area and therefore more accurate detection of activity changes at the level of the vessels themselves. Other authors have also described a significant decrease in aCNV after anti-VEGF treatment and a renewed increase possibly accompanied by exudation 13 26. In contrast, Xu et al 27 described a general increase in the size of CNV under anti-VEGF therapy, and Carnevali et al 28 observed a growth in size of quiescent CNV without correlation to clinical activity.…”

Section: Discussionmentioning

confidence: 99%

Changes in the OCT angiographic appearance of type 1 and type 2 CNV in exudative AMD during anti-VEGF treatment

et al. 2019

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ObjectiveOptical coherence tomography angiography (OCT-A) enables detailed visualisation of the vascular structure of choroidal neovascularisation (CNV). The aim of this study was to determine whether mathematically ascertained OCT-A vascular parameters of type 1 and type 2 CNV in exudative age-related macular degeneration (AMD) change during antivascular endothelial growth factor (anti-VEGF) treatment. The OCT-A vascular parameters were also compared with previously obtained activity parameters (fluid distribution on spectral domain OCT (SD-OCT)) to establish whether they could potentially be used as further ‘activity parameters’ for assessment of anti-VEGF treatment.Methods and AnalysisWe evaluated 27 eyes of 27 patients (mean follow-up 9.8 months) with type 1, type 2 or mixed CNV who had received anti-VEGF treatment (IVAN scheme). The parameters analysed were area (aCNV), total length of all vessels (tlCNV), overall number of vascular segments (nsCNV) and fractal dimension (FD) of the CNV. The changes in each of these parameters were correlated with the central foveal thickness (CFT).ResultsRegression and renewed perfusion of the CNV corresponded with the decrease or increase, respectively, of macular fluid distribution on SD-OCT. The increase and decrease of CFT during anti-VEGF treatment were highly significantly correlated with changes in FD (p<0.00001), aCNV (p<0.00001), tlCNV (p<0.00001) and nsCNV (p<0.00001).ConclusionOCT-A enables detailed analysis of AMD with regard to FD, aCNV, tlCNV and nsCNV. As the changes in these parameters correlate closely with changes on SD-OCT, they can be used as new activity parameters, alongside fluid distribution, for assessment of treatment effect and as parameters of stabilisation or the need for repeated treatment.

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Section: Discussionmentioning

confidence: 99%

Changes in the OCT angiographic appearance of type 1 and type 2 CNV in exudative AMD during anti-VEGF treatment

et al. 2019

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“…Additionally, polypoidal choroidal vasculopathy is also considered as a variation of this type CNV [14,15]. In newly studies, it has been reported that OCTA provides more precisely and comprehensively describe of Type 1 CNV in AMD [16][17][18][19]. Thus, OCTA can also be used for early detection of an occult CNV (Type 1 CNV) in this AOR in the eyes with asymptomatic eyes in the stages of early or intermediate AMD.…”

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confidence: 99%

The Importance of VRI and AOR Segmentations in Optical Coherence Tomography Angiography

Turgut

2017

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In this editorial, it was aimed to call attention to the importance of the screening and the evaluation of the segmentations of vitreoretinal interface and avascular outer retina in optical coherence tomography angiography for subclinical or early pre-retinal and choroidal neovascularization. In optical coherence tomography angiography of a healthy subject, both segmentations of vitreoretinal interface and avascular outer retina do not show obvious vascular structure. Thus, these two segmentations can be used for the screening of preretinal and choroidal neovascularization in various ischemic vascular diseases. Keywords EditorialOptical coherence tomography angiography (OCTA) is a very useful angiography type for the evaluation of both retinal and choroidal vasculature. OCTA is noninvasive imaging method without adverse effects because the usage of a contrast agent is not needed in this imaging method. Using by OCTA, the vasculature and blood flow of retina and choroid can be visualized in detail through detecting motion contrast of erythrocytes in the vessel, using serial optical coherence tomography B-scans. OCTA has an ability to perform the separate segmentations including the vitreoretinal interface (VRI), the superficial retinal layer, the deep retinal layer, avascular outer retina (AOR), the choriocapillaris and the choroid (Figure 1) [1][2][3][4][5][6][7][8].In a healthy eye, the VRI has no vascular structure though the ganglion cell layer of the retina has the superficial retinal capillary plexus based on vitreo-retinal histology and VRI segmentation of OCTA (Figure 1, VRI) [1][2][3][4][5][6][7][8]. Preretinal neovascularization (PNV) is characterized by networks of vessels lying on the surface of the retina and invading the cortical vitreous gel and extending into the vitreous cavity. PNV usually occurs in the ischemic retinal vascular diseases such as proliferative diabetic retinopathy, retinal vein occlusion, retinopathy of prematurity and sickle-cell disease retinopathy [9][10][11][12][13]. PNV in earlier stages of the pathogenesis of abnormal neovascularization event may be overlooked. VRI segmentation of OCTA can be used to screen and detect the early or subclinical PNV in these diseases [9][10][11][12].In the other hand, both the histological examinations and OCTA reports of retina in healthy subjects demonstrated that there is an avascular retinal region (avascular outer retina, AOR) in the deep or outer layer of the retina. AOR is the layer between the outer plexiform layer (OPL) in the inner border and ellipsoid zone in the outer border. The outer retina segmentation between the OPL and Bruch membrane by OCTA show no vascular blood flow in a normal eye (Figure 1, Avascular) [1][2][3][4][5][6][7][8]. Choroidal neovascularization (CNV) defines the development of the new blood vessels derived the choroid and the invasion into sub-retinal pigment epithelium (RPE) or subretinal space via a break in Bruch membrane. Type 1 choroidal neovascularization (CNV) is characterized by vessels prolif...

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Einfluss der CNV-Gefäßmorphologie bei exsudativer altersabhängiger Makuladegeneration auf die Visusentwicklung und den Anti-VEGF-Therapiebedarf nach 1 Jahr

et al. 2020

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Analysis and follow-up of type 1 choroidal neovascularisation with optical coherence tomography–angiography after antiangiogenic treatment

Cited by 4 publications

References 20 publications

Changes in the OCT angiographic appearance of type 1 and type 2 CNV in exudative AMD during anti-VEGF treatment

Changes in the OCT angiographic appearance of type 1 and type 2 CNV in exudative AMD during anti-VEGF treatment

The Importance of VRI and AOR Segmentations in Optical Coherence Tomography Angiography

Einfluss der CNV-Gefäßmorphologie bei exsudativer altersabhängiger Makuladegeneration auf die Visusentwicklung und den Anti-VEGF-Therapiebedarf nach 1 Jahr

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