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Clinical science
Early OCT angiography changes of type 1 CNV in exudative AMD treated with anti-VEGF
  1. Elisabetta Pilotto1,
  2. Luisa Frizziero2,
  3. Anna Rita Daniele1,
  4. Enrica Convento1,
  5. Evelyn Longhin1,
  6. Francesca Guidolin1,
  7. Raffaele Parrozzani1,
  8. Fabiano Cavarzeran1,
  9. Edoardo Midena1,2
  1. 1 Department of Ophthalmology, University of Padova, Padova, Italy
  2. 2 G.B. Bietti Foundation, IRCCS, Rome, Italy
  1. Correspondence to Professor Edoardo Midena, Department of Ophthalmology, University of Padova, 35128 Padova, Italy; edoardo.midena{at}unipd.it

Abstract

Aims To investigate, with optical coherence tomography angiography (OCTA), short-term changes of type 1 choroidal neovascularisation (CNV), secondary to exudative age-related macular degeneration, after anti-vascular endothelial growth factor (VEGF) treatment.

Methods Patients affected by type 1 CNV treated with intravitreal anti-VEGF were consecutively enrolled. All patients underwent OCTA examination before and 48 hours after anti-VEGF treatment. Quantitative and qualitative vascular and morphological macular changes were evaluated.

Results Sixteen eyes were included (11 treated with aflibercept and 5 with ranibizumab). Both CNV mean area and pigment epithelium detachment significantly reduced (p=0.0004 and p=0.0007, respectively) after treatment. Cystoid macular oedema (four eyes) decreased in all cases. Neuroretinal detachment (13 eyes) decreased in 85% of cases (11 eyes). Fine CNV vessels density decreased in 75% (12 eyes), whereas larger CNV vessels density remained stable in 66.7% (10 eyes), choroidal flow void signal (7 eyes at baseline) increased in 42.9% (3 eyes) of them and remained stable in 57.1% (4 eyes). Interoperator reproducibility for OCT examination was good for all measurements (intraclass correlation coefficient>0.65).

Conclusion Early remodelling of type 1 CNV network after treatment may be non-invasively and reproducibly analysed by means of OCTA. Choroidal perfusion impairment, choroidal flow void signal, surrounding CNV may change during treatment.

  • macula
  • neovascularisation
  • retina
  • imaging
  • treatment other

https://doi.org/10.1136/bjophthalmol-2017-311752

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    Footnotes

    • LF and ARD contributed equally.

    • Contributors EP and EM: substantial contributions to conception and design, acquisition of data or analysis and interpretation of data; drafting the article or revising it critically for important intellectual content and final approval of the version to be published. LF and ARD: substantial contributions to design, acquisition of data or analysis and interpretation of data; drafting the article or revising it critically for important intellectual content and final approval of the version to be published. EC and EL: substantial contributions to acquisition of data or analysis and interpretation of data; revising the article critically for important intellectual content and final approval of the version to be published. FG: substantial contributions to acquisition of data or analysis and interpretation of data; revising the article critically for important intellectual content and final approval of the version to be published. RP: substantial contributions drafting the article or revising it critically for important intellectual content and final approval of the version to be published. FC: statistical analysis of data and final approval of the version to be published.

    • Funding The research contribution by the G.B. Bietti Foundation was supported by Fondazione Roma and Ministry of Health.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval Institutional Review Board of Azienda sanitaria di Padova.

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

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