Fundus Autofluorescence Changes After Ranibizumab Treatment for Subfoveal Choroidal Neovascularization Secondary to Pathologic Myopia

Parodi, Maurizio Battaglia; Iacono, Pierluigi; Sacconi, Riccardo; Iuliano, Lorenzo; Bandello, Francesco

doi:10.1016/j.ajo.2015.04.030

Cited by 14 publications

(2 citation statements)

References 18 publications

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“…The presence of a reactive, hyperautofluorescent ring is partially confirmed by AF imaging, where the main finding, unlike to a recent report by Parodi et al, 28 was a hypo-hyperautofluorescent (“patchy”) rather than a hyperautofluorescent lesion. Autofluorescence is related to the presence of lipofuscin in the RPE, and is probably due to the displacement of macular pigments and subsequent increased exposure of lipofuscin.…”

Section: Discussionmentioning

confidence: 57%

Multimodal imaging and diagnosis of myopic choroidal neovascularization in Caucasians

Milani¹,

Massacesi²,

Moschini³

et al. 2016

OPTH

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PurposeTo investigate myopic choroidal neovascularization (mCNV) by fluorescein angiography (FA), spectral-domain optical coherence tomography (SD-OCT), near-infrared (NIR) reflectance, and autofluorescence (AF).MethodsThis retrospective study included 65 eyes of 62 Caucasian patients with a mean age of 66.72 years (95% confidence interval [CI] 63–70 years) and a mean refraction of −9.72 diopters (95% CI −8.74 to −10.70 diopters).ResultsMost of the mCNV cases were foveal-juxtafoveal (60/65, 92.3%), with thickening of the corresponding retina (62/65, 95.3%) and leakage on FA (44/65, 67.6%). No retinal fluid was detectable in 32 (49.2%) eyes and there was no hemorrhage in 25 (38.4%) eyes. Papillary chorioretinal atrophy was evident in 58 (89.2%), a shadowing effect in 48 (73.8%), and an epiretinal membrane in 38 (58.4%) eyes. If an area of macular chorioretinal atrophy was present, mCNV frequently developed adjacent to it and was hyperfluorescent rather than with leakage (P⩽0.001). In eyes with edema or hemorrhage, hyper-reflective foci were more frequent (P⩽0.005). NIR and AF features were indeterminable in 19 (29.2%) and 27 (41.5%) eyes, respectively. The predominant feature was black or grayish on NIR (34/65, 52.3%) and patchy (hypo- and hyperfluorescence was observed) on AF (25/65, 38.4%). FA and SD-OCT correctly detected mCNV in 49 (75.3%) and 48 (73.8%) eyes, respectively, whereas NIR and AF exhibited limited diagnostic sensitivity. Doubtful diagnosis was associated with hyperfluorescent mCNV (P⩽0.001), absence of retinal fluid and epiretinal membrane (P⩽0.05), and presence of macular chorioretinal atrophy (P⩽0.01).ConclusionTomographic, angiographic, AF, and NIR features of mCNV are described in this study. Combination of SD-OCT and FA is recommendable for diagnosis.

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Section: Discussionmentioning

confidence: 57%

Multimodal imaging and diagnosis of myopic choroidal neovascularization in Caucasians

Milani¹,

Massacesi²,

Moschini³

et al. 2016

OPTH

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“…The former has a scarce impact on the visual outcome and enables a wait-and-see approach until complete blood reabsorption. On the other hand, the latter needs prompt treatment, based on intravitreal anti-VEGF therapy, and a regular follow-up for an early diagnosis of relapses [25]. However, discerning the origin of the subretinal bleeding is not always predictable, even with the most sophisticated imaging technique.…”

Section: Discussionmentioning

confidence: 99%

Discerning Between Macular Hemorrhages Due to Macular Neovascularization or Due to Spontaneous Bruch’s Membrane Rupture in High Myopia: A Comparative Analysis Between OCTA and Fluorescein Angiography

et al. 2022

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Introduction: To evaluate the sensitivity and specificity of optical coherence tomography angiography (OCTA) in comparison to fluorescein angiography (FA) in discerning between macular hemorrhages due to myopic macular neovascularization (m-MNV) and idiopathic macular hemorrhage (IMH) in patients with high myopia (HM). Methods: In this retrospective study, 14 eyes of 14 patients (mean age 60 ± 16 years) affected by macular hemorrhage due to HM were included. All patients underwent OCTA and FA at the time of macular hemorrhage (i.e., baseline) and were followed for a 3-month followup. Results: By means of FA, 8 out of 14 eyes with macular hemorrhage (57%) were diagnosed as type 2 m-MNV, whereas 6 eyes (43%) were diagnosed as IMH. Interestingly, OCTA displayed the presence of a neovascular network in all cases previously diagnosed as m-MNV using FA, and also excluded the presence of anomalous flow in all IMH eyes. This accounted for the high sensitivity and specificity of OCTA for m-MNV detection in HM cases with macular hemorrhage. After 3-month follow-up, BCVA improved from 0.39 ± 0.15 to 0.21 ± 0.14 logMAR (p = 0.006) in patients with m-MNV treated by a mean of 2.3 ± 0.9 intravitreal anti-VEGF injections. Conversely, BCVA improved without treatment (from 0.55 ± 0.48 to 0.17 ± 0.08 logMAR, p = 0.112) in patients with IMH. Conclusions: OCTA is able to differentiate with excellent reliability between the presence of m-MNV in patients with HM presenting with a new macular hemorrhage and an IMH. This could be of paramount relevance in the clinical setting for the diagnosis and treatment of patients with HM.

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Long-term outcomes of myopic choroidal neovascularisation treated with combined ranibizumab and dexamethasone characterised by multi-modal imaging

Tan

Teo

Guan

et al. 2016

Graefes Arch Clin Exp Ophthalmol

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Fundus Autofluorescence Changes After Ranibizumab Treatment for Subfoveal Choroidal Neovascularization Secondary to Pathologic Myopia

Cited by 14 publications

References 18 publications

Multimodal imaging and diagnosis of myopic choroidal neovascularization in Caucasians

Multimodal imaging and diagnosis of myopic choroidal neovascularization in Caucasians

Discerning Between Macular Hemorrhages Due to Macular Neovascularization or Due to Spontaneous Bruch’s Membrane Rupture in High Myopia: A Comparative Analysis Between OCTA and Fluorescein Angiography

Long-term outcomes of myopic choroidal neovascularisation treated with combined ranibizumab and dexamethasone characterised by multi-modal imaging

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