Long-term Progression of Type 1 Neovascularization in Age-related Macular Degeneration Using Optical Coherence Tomography Angiography

Xu, David; Dávila, Juan Pablo Martínez; Rahimi, Masoud; Rebhun, Carl B; Alibhai, A. Yasin; Waheed, Nadia K.; Sarraf, David

doi:10.1016/j.ajo.2017.12.005

Cited by 93 publications

(86 citation statements)

References 39 publications

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“…Similarly, in agreement with the results of the study by Xu et al, we observed 3 CNV growth patterns: symmetric growth, asymmetric growth, and finger-like projections [19]. Furthermore, we observed a new entity of CNV growth, "inside the fibrous capsule."…”

supporting

confidence: 92%

Type 1 Choroidal Neovascularization Evolution by Optical Coherence Tomography Angiography: Long-Term Follow-Up

Rispoli¹,

Savastano

Lumbroso³

et al. 2020

BioMed Research International

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Purpose. To evaluate structural changes in response to antivascular endothelial growth factor (anti-VEGF) treatment in patients with long-term type 1 choroidal neovascularization (CNV) by optical coherence tomography (OCT) and OCT angiography (OCTA). Method. This is a longitudinal study that involved a total of 51 eyes with type 1 CNV (35 female and 16 male eyes). Structural OCT and OCTA were performed on all the subjects. AngioVue OCTA (XR Avanti, Optovue, Inc., Fremont, CA) was used to obtain qualitative and quantitative information. All eyes were treated with an anti-VEGF ProReNata (PRN) approach and were followed for a mean of 38.9 months (SD±7.22). Best-corrected visual acuity (BCVA) was assessed at each follow-up timepoint. Results. We observed two kinds of possible evolution of type 1 CNV: “positive evolution,” including stabilization in 20% of patients and chronicity in 35%, and “negative evolution,” in which fibrosis was shown in 18% of patients, chorioretinal atrophy in 25%, and hemorrhage or RPE tears in 2%. The mean BCVA at baseline was 33.67±15.85 ETDRS letters; after 1 and 2 years, it was 31.61±18.04 and 31.18±18.58 ETDRS letters, respectively. The mean BCVA at the end of follow-up was 25.27±20 ETDRS letters. The difference between the values at baseline and at the end of follow-up was not statistically significant (P=0.06, r2=0.10). Conclusions. This study describes an in vivo structural long-term evolution of type 1 CNV by OCT and OCTA. Different possible CNV outcomes were observed. This study suggests that new retinal imaging techniques could be useful tools for assessing the potential retinal changes in the evolution of type 1 CNV to develop personalized medicine. Further studies using OCTA in the long term are needed to better understand why similarly treated type 1 CNV cases evolve differently and produce different results.

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confidence: 92%

Type 1 Choroidal Neovascularization Evolution by Optical Coherence Tomography Angiography: Long-Term Follow-Up

Rispoli¹,

Savastano

Lumbroso³

et al. 2020

BioMed Research International

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“…V ascularized pigment epithelial detachment (PED) is a common variant of neovascular age-related macular degeneration (AMD) and is most often associated with type 1 neovascularization (NV) previously referred to as occult choroidal neovascularization (CNV). [1][2][3][4][5][6][7][8][9][10][11] Pigment epithelial detachments can assume various morphologic configurations, and a number of different terms have been used to describe PED formation in neovascular AMD, including fibrovascular PED, vascularized serous PED (vsPED), and more recently multilayered PED. 3,[12][13][14] Type 1 NV accounts for up to 40% to 50% of newly diagnosed treatment-naïve patients with exuda-tive AMD.…”

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confidence: 99%

“…14 Optical coherence tomography (OCT) and OCT angiography (OCTA) provide depth-resolved capability and enhanced microvascular resolution of type 1 NV through the PED and present an opportunity for the first time to sequentially study the evolution of NV in association with a PED and gain insight into the mechanisms of progression. 6,13,[24][25][26] Three-dimensional volumetric OCT and OCTA reconstruction may be especially powerful to display the dynamic interplay and progression of NV within the PED. 27 Given the noninvasive nature and ease and facility of scan acquisition, frequent follow-up imaging can be performed to precisely monitor the evolution and progression of type 1 NV associated with PED and its morphologic response to anti-VEGF therapy.…”

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confidence: 99%

Volumetric Analysis of Vascularized Serous Pigment Epithelial Detachment Progression in Neovascular Age-Related Macular Degeneration Using Optical Coherence Tomography Angiography

Hou

Dávila

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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“…Bisherige OCTA-Studien haben Gefäßveränderungen der CNV unter Anti-VEGF beschrieben [8,9,16,17,19,22,23], dennoch fehlen bislang vergleichbare phänotypische Ausprägungen der fibrosierten CNV.…”

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“…Die Gefäßmorphologie von Cluster 1 wird durch wenige, lange und großkalibrige Segmente, die Gefäßmorphologie von Cluster 2 durch viele, kurze und kleinkalibrige Segmente charakterisiert. Bisherige Arbeiten konnten zeigen, dass die CNV-Morphologie in der OCTA mit der Maturität und Aktivität korrelieren kann [22,23]. Die vorliegende Arbeit zeigt, dass gefäßmorphologische Cluster auch unabhängig von der Krankheitsaktivität erfasst werden können.…”

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Analysis of the Vascular Morphology of the Fibrotic Choroidal Neovascularization in Neovascular Age-Related Macular Degeneration Using Optical Coherence Tomography Angiography

Book

Ziegler

Rothaus

et al. 2020

Klin Monbl Augenheilkd

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Purpose Choroidal neovascularization (CNV) in neovascular age-related macular degeneration (nAMD) undergoing anti-VEGF therapy transforms into a fibrotic lesion. This fibrovascular transformation is associated with a great variety of functional and morphological effects. The aim of this study was to investigate the vascular morphology of fibrotic CNV, to compare it with its surrounding tissue and to identify phenotypes using optical coherence tomography angiography (OCTA). Methods In 18 eyes with fibrotic CNV in nAMD spectral domain OCT (SD-OCT) and OCTA were performed. The automated segmentation lines were manually adjusted. A slab from 60 µm beneath Bruchʼs membrane to the inner edge of the subretinal hyperreflective material was applied. Quantitative analysis of the vascular morphology was performed using skeletonized OCTA images. Results Compared to the perilesional rim, the number of segments per area was significantly lower (234.75 ± 25.68 vs. 255.30 ± 20.34 1/mm2, p = 0.0003) within the fibrovascular lesion. Two phenotypes could be identified within the lesion. The phenotypic traits of cluster 1 were few, long and thick vascular segments; Cluster 2 was characterized by many, short and thin vascular segments (number of segments per area: 219.4 ± 18.8 vs. 258.8 ± 13.2 1/mm2, p = 0.00009, segment length: 49.6 ± 2.7 vs. 45.0 ± 1.3 µm, p = 0.0002, vascular caliber: 26.6 ± 1.2 vs. 23.5 ± 1.8 µm, p = 0.003). The clusters did not differ significantly regarding visual acuity (0.52 ± 0.44 vs. 0.54 ± 0.18 logMAR, p = 0.25), differentiability of subretinal (OR = 3.43, CI = [0.30, 39.64], p = 0.6) and intraretinal fluid (OR = 5.34, CI = [0.48, 89.85], p = 0.14). Less normalized ellipsoid zone (EZ) loss could be observed in cluster 1 (131.0 ± 161.3 vs. 892.4 ± 955.6 1/m, p = 0.006). Conclusion In this study the vascular morphology of fibrotic CNV was analyzed using OCTA. Differences between the lesion and a perilesional rim could be detected. Two phenotypes within the fibrovascular lesion were identified. These morphological clusters could indicate different patterns of fibrovascular transformation of the CNV under long-term anti-VEGF therapy and be useful identifying possible predictive biomarkers in future studies.

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Long-term Progression of Type 1 Neovascularization in Age-related Macular Degeneration Using Optical Coherence Tomography Angiography

Cited by 93 publications

References 39 publications

Type 1 Choroidal Neovascularization Evolution by Optical Coherence Tomography Angiography: Long-Term Follow-Up

Type 1 Choroidal Neovascularization Evolution by Optical Coherence Tomography Angiography: Long-Term Follow-Up

Volumetric Analysis of Vascularized Serous Pigment Epithelial Detachment Progression in Neovascular Age-Related Macular Degeneration Using Optical Coherence Tomography Angiography

Analysis of the Vascular Morphology of the Fibrotic Choroidal Neovascularization in Neovascular Age-Related Macular Degeneration Using Optical Coherence Tomography Angiography

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