Using optical coherence tomography angiography to guide myopic choroidal neovascularization treatment: a 3-year follow-up study

Author(s):  
Tomoko Ueda-Consolvo ◽  
Noriko Shibuya ◽  
Toshihiko Oiwake ◽  
Shinya Abe ◽  
Ayaka Numata ◽  
...  
2018 ◽  
Vol 29 (2) ◽  
pp. 239-243
Author(s):  
Gilda Cennamo ◽  
Francesca Amoroso ◽  
Stefano Schiemer ◽  
Nunzio Velotti ◽  
Mariacristina Alfieri ◽  
...  

Purpose: To describe the optical coherence tomography angiography characteristics of myopic patients with choroidal neovascularization secondary to pathologic myopia during ranibizumab therapy. Methods: Nineteen patients were enrolled in this prospective study (13 females, 6 males, mean age 55.25 ± 9.63 years) for a total of 20 eyes examined (14 right eyes, 6 left eyes). Images were analyzed independently by two examiners. Results: Mean follow-up was 5.75 ± 1.88 months, with a mean intravitreal injections of 1.90 ± 0.44. Mean best-corrected visual acuity at baseline was 0.39 ± 0.18 logMAR versus 0.26 ± 0.16 logMAR 6 months after treatment. The neovascular area (Z = –2.091, p = 0.037) was significantly reduced after treatment, whereas vessel density was not (Z = –1.848, p = 0.065). Moreover, the best-corrected visual acuity was increased (Z = –3.055, p = 0.002). Neovascular area was significantly correlated with best-corrected visual acuity, at both baseline and follow-up (p < 0.05). Conclusion: Our data suggest that optical coherence tomography angiography is a reproducible non-invasive examination with which to monitor changes in the neovascular area in patients with pathologic myopia treated with ranibizumab.


2019 ◽  
pp. 112067211988233 ◽  
Author(s):  
Pierluigi Iacono ◽  
Paola Giorno ◽  
Monica Varano ◽  
Mariacristina Parravano

Purpose: To evaluate the agreement between fluorescein angiography and structural optical coherence tomography in diagnosing and monitoring the activity of myopic choroidal neovascularization and to provide a comparative analysis with optical coherence tomography angiography. Methods: Thirteen patients with active myopic choroidal neovascularization were prospectively enrolled. At the baseline, 2-month, and 6-month visits, each patient underwent a complete ophthalmological examination, including best-corrected visual acuity assessment, fundus examination, fluorescein angiography, and optical coherence tomography with structural and angiographic assessment. Sensitivity and specificity for all optical coherence tomography parameters were evaluated taking fluorescein angiography as the reference examination. Results: At the baseline, fluorescein angiography confirmed myopic choroidal neovascularization leakage in all patients. Structural optical coherence tomography demonstrated intraretinal or subretinal fluid in 61% of cases, fuzzy borders and absence of external limiting membrane visibility in 84% of cases, and subretinal hyperreflective exudation in 53% of cases. Sensitivity to the presence of retinal fluid and subretinal hyperreflective exudation was lower than sensitivity to fuzzy borders and external limiting membrane visibility, which reached 84%. During ranibizumab therapy, external limiting membrane visibility showed a higher sensitivity (100%) compared with fuzzy borders and subretinal hyperreflective exudation (66.6%) while displaying an equal specificity of 100%. At baseline and final visit, sensitivity increased to 100% when all structural optical coherence tomography parameters were pooled. Optical coherence tomography angiography detected myopic choroidal neovascularization at baseline, 2-month, and 6-month visits in 92%, 76%, and 76% of cases, respectively. Conclusion: The study confirms that the new indicators of myopic choroidal neovascularization activity are more reliable than the presence or absence of retinal fluid. Optical coherence tomography angiography identified myopic choroidal neovascularization in most patients in the diagnostic phase and during treatment monitoring and could be considered as an alternative to fluorescein angiography in selected patients.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yun Zhang ◽  
Jia Fang ◽  
Shixin Zhao ◽  
Xiangjun She ◽  
Jun Wang ◽  
...  

Abstract Background Choroidal osteoma is a benign intraocular tumor that can increase risk of developing choroidal neovascularization. The visual prognosis is influenced by the tumor location, decalcification status, overlying RPE atrophy, presence of choroidal neovascularization, persistence of subretinal fluid and occurrence of subretinal hemorrhages. Case presentation The authors present a 40-year-old woman diagnosed with choroidal osteoma of the right eye. Her best corrected visual acuity was 12/20 but decreased to 5/20 due to secondary choroidal neovascularization after 8 years follow up. Fundus examination revealed an enlarged choroidal osteoma in most margins at posterior pole with schistose hemorrhage beside macula. Optical coherence tomography angiography revealed unique features in the vascular changes of choroidal neovascularization in choroidal osteoma in the outer retinal layer and choroid capillary layers, and subretinal neovascularization. Indocyanine green fluorescence angiography showed there was hypo-fluorescence at the peripapillary with faint hyper-fluorescence at the macular, corresponding to the location on the fundus photograph. The patient received 3 injections of intravitreal ranibizumab. After 1 year follow up, her visual acuity of the right eye was 18/20 and the CNV had regressed. Conclusions We present the findings and treatment of a case of choroidal osteoma with secondary choroidal neovascularization. Optical coherence tomography angiography combined with FFA and ICGA is used to analysis the characteristics of secondary choroidal neovascularization. Optical coherence tomography angiography can reveal some unique characteristics in the vascular changes compared to fundus fluorescein angiography.


2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
T. Y. Alvin Liu ◽  
Alice Yang Zhang ◽  
Adam Wenick

A 37-year-old Caucasian woman presented with acute decrease in central vision in her right eye and was found to have subfoveal choroidal neovascularization (CNV) due to presumed ocular histoplasmosis syndrome (POHS). Her visual acuity improved from 20/70 to 20/20 at her 6-month follow-up, after 3 consecutive monthly intravitreal bevacizumab injections were initiated at her first visit. Although no CNV activity was seen on fluorescein angiography (FA) or spectral-domain optical coherence tomography (SD-OCT) at her 2-month, 4-month, and 6-month follow-up visits, persistent flow in the CNV lesion was detected on optical coherence tomography angiography (OCTA). OCTA shows persistent vascular flow as well as changes in vascular flow in CNV lesions associated with POHS, indicating the continued presence of patent vessels and changes in these CNV lesions, even when traditional imaging of the lesion with OCT and FA indicates stability of the lesion with no disease activity. Additional cases with longitudinal follow-up are needed to assess how OCTA should be incorporated into clinical practice.


2020 ◽  
pp. 112067212093496
Author(s):  
Ya Ma ◽  
Huiying Zhao ◽  
Xiaoyan Peng

Purpose: To describe a case of primary vitreous retinal lymphoma (PVRL) complicated with choroidal neovascularization (CNV) and presented with severe macular edema (ME). Case description: A 52-year-old female patient was diagnosed with bilateral PVRL. Optical coherence tomography (OCT) showed severe macular edema (ME) and subretinal hyperreflective material in the left eye at the first visit. No sign of choroidal neovascularization (CNV) was found with fundus fluorescein angiography (FFA) or indocyanine green angiography (ICGA). The ME was resolved after standard intraocular chemotherapy, while the subretinal hyperreflective material remained stable. Optical coherence tomography angiography (OCTA) was performed 2 years after chemotherapy. OCTA revealed a well-circumscribed CNV network in the subretinal hyperreflective material. Conclusion: It is a rare occurrence that CNV and ME developed in this PVRL patient. The presence of ME is not an exclusion criterion for PVRL. This case should also raise awareness of the importance of OCTA as a method for monitoring intraocular lymphoma during follow-up.


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