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OCT-A characterisation of recurrent type 3 macular neovascularisation
  1. Riccardo Sacconi1,2,
  2. Marco Battista1,2,
  3. Enrico Borrelli1,2,
  4. Alexandra Miere3,
  5. Eleonora Corbelli1,2,
  6. Vittorio Capuano3,
  7. Lea Querques2,
  8. Eric H Souied3,
  9. Francesco Bandello1,2,
  10. Giuseppe Querques1,2
  1. 1School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
  2. 2Division of head and neck, Ophthalmology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
  3. 3Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil, Creteil, France
  1. Correspondence to Professor Giuseppe Querques, Ophthalmology, Ospedale San Raffaele, Milano 20132, Italy; giuseppe.querques{at}hotmail.it

Abstract

Purpose To investigate optical coherence tomography angiography (OCT-A) findings in recurrent type 3 macular neovascularisation (MNV).

Methods In this retrospective cohort study, consecutive patients with type 3 MNV secondary to age-related macular degeneration underwent OCT-A at three different time points: baseline, after anti-vascular endothelial growth factor treatment with complete resolution of the exudative signs (ie, non-exudative stage) and at the recurrence of exudation (ie, recurrence stage). Demographics and clinical findings were analysed, including OCT-A features of type 3 MNV recurrence.

Results Twelve eyes (12 patients, mean age 78±7 years) were included. Using OCT-A, at baseline all type 3 MNVs showed the presence of detectable flow downgrowing from the deep vascular complex (DVC) to the retinal pigment epithelium (RPE)/sub-RPE space. 6/12 eyes (50%) showed anomalous flow under the RPE, while the other 6 eyes showed flow reaching the RPE without anomalous flow in the sub-RPE space. At the non-exudative stage (after treatment), BCVA and CMT significantly improved (p=0.004 and p=0.036), and flow inside the retinal lesions reduced; interestingly the connection to the RPE/sub-RPE space regressed. At the time of recurrence, all type 3 MNVs showed the presence of intra/sub-retinal exudation with restoration of the flow deepening from the DVC to the RPE/sub-RPE space.

Conclusions Detectable flow deepening from the DVC to the RPE/sub-RPE space using OCT-A is mandatory to have a new exudation secondary to recurrent type 3 MNV. Early detection of type 3 MNV recurrence by OCT-A characterisation may prompt retreatment and potentially prevent progression to late stages of the disease.

  • imaging
  • macula
  • retina
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Footnotes

  • Contributors RS, MB, GQ: research design, data acquisition and analysis, interpretation of data, drafting the manuscript and critical revision of the manuscript. EB, AM, EC, VC: data acquisition and analysis, critical revision of the manuscript. LQ, EHS, FB: interpretation of data and critical revision of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests RS, EB and VC are consultants for ZEISS (Dublin, USA). FB is a consultant for: Alcon (Fort Worth,Texas,USA), Alimera Sciences (Alpharetta, Georgia, USA), Allergan Inc (Irvine, California, USA), Farmila-Thea (Clermont-Ferrand, France), Bayer Shering-Pharma (Berlin, Germany), Bausch + Lomb (Rochester, New York, USA), Genentech (San Francisco, California, USA), Hoffmann-La-Roche (Basel, Switzerland), Novagali Pharma (Évry, France), Novartis (Basel, Switzerland), Sanofi-Aventis (Paris, France), Thrombogenics (Heverlee,Belgium), Zeiss (Dublin, USA). EHS is a consultant for: Allergan Inc (Irvine, California, USA), Bausch + Lomb (Rochester, New York, USA), Bayer Shering-Pharma (Berlin, Germany), Novartis (Basel, Switzerland). GQ is a consultant for: Alimera Sciences (Alpharetta, Georgia, USA), Allergan Inc (Irvine, California, USA), Amgen (Thousand Oaks, USA), Bayer Shering-Pharma (Berlin, Germany), Heidelberg (Germany), KBH (Chengdu; China), LEH Pharma (London, UK), Lumithera (Poulsbo, USA), Novartis (Basel, Switzerland), Sandoz (Berlin, Germany), Sifi (Catania, Italy), Sooft-Fidea (Abano, Italy), ZEISS (Dublin, USA).

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Data are available upon request from GQ (giuseppe.querques@hotmail.it).

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