Optical coherence tomography angiography changes in early type 3 neovascularization after anti-vascular endothelial growth factor treatment

Purpose. We investigated two factors linked to diabetic macular edema (DME), vitreous and serum levels of vascular endothelial growth factor (VEGF) and uric acid (UA) in patients with DME, and compared the results with changes in optical coherence tomography (OCT) and visual acuity (VA).Methods. A prospective study of 29 eyes, 16 cystoid DME and nonproliferative diabetic retinopathy (DR) and 13 nondiabetic controls. Biochemical analysis of vitreous and serum samples was performed and OCT scans were graded according to central retinal thickness (CRT), cube volume (CV), cube average thickness (CAT), and serous retinal detachment (SRD).Results. In DME group, intravitreal concentrations of VEGF (p<0.001), UA (p=0.038), and total protein (p<0.001) were significantly higher than in control group. In DME subjects, intravitreal UA correlated significantly with intravitreal VEGF (ƍ= 0.559,p=0.03) but not with total vitreous protein and serum UA. Increased intravitreal VEGF in DME group correlated with increase in CV (ƍ= 0.515/p=0.041). None of the OCT parameters correlated with the VA.Conclusions. The results suggest that the CV might be assessor of anti-VEGF therapy efficacy. Second, apart from VEGF, the role of UA in the pathogenesis and progression of DR should be considered.

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Choroidal neovascularization due to choroidal osteoma treated with anti–vascular endothelial growth factor therapy: An optical coherence tomography angiography study

European Journal of Ophthalmology ◽

10.1177/1120672118792187 ◽

2018 ◽

Vol 29 (3) ◽

pp. 323-329 ◽

Cited By ~ 3

Author(s):

Claudio Furino ◽

Luca Di Antonio ◽

Maria Oliva Grassi ◽

Marco Rispoli ◽

Michele Reibaldi ◽

...

Keyword(s):

Vascular Endothelial Growth Factor ◽

Optical Coherence Tomography ◽

Growth Factor ◽

Choroidal Neovascularization ◽

Optical Coherence Tomography Angiography ◽

Vascular Endothelial ◽

Optical Coherence ◽

Choroidal Osteoma ◽

Growth Factor Therapy ◽

Endothelial Growth Factor

Purpose: To evaluate the response to anti–vascular endothelial growth factor therapy for choroidal neovascularization secondary to choroidal osteoma using optical coherence tomography angiography. Methods: This retrospective study included four eyes of four females with choroidal osteoma complicated by choroidal neovascularization, treated with ranibizumab. All patients underwent full ophthalmologic examination, including ocular ultrasound, retinography, fluorescein angiography, spectral-domain or swept-source optical coherence tomography, and optical coherence tomography angiography. These images were analyzed to measure choroidal osteoma and to study choroidal neovascularization changes after intravitreal anti–vascular endothelial growth factor. Results: In all cases, fluorescein angiography revealed the presence the choroidal neovascularization, as an early hyperfluorescence area increasing during the exam. Optical coherence tomography showed both the choroidal osteoma and choroidal neovascularization and intra- or subretinal fluid as activity sign. In optical coherence tomography angiography, choroidal osteoma vessels were valuable in outer retina and choroidal slabs, and were irregular and did not change after ranibizumab injection; neovascular network correlating with choroidal neovascularization showed a hyperflow tangled vessels in outer retina, decreasing in density after anti–vascular endothelial growth factor therapy. Conclusion: Optical coherence tomography angiography seems to be a useful tool in visualizing and distinguishing vascular networks of choroidal osteoma and of choroidal neovascularization secondary to choroidal osteoma better than fluorescein angiography.

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Changes in retinal and choriocapillaris density in diabetic patients receiving anti-vascular endothelial growth factor treatment using optical coherence tomography angiography

International Journal of Retina and Vitreous ◽

10.1186/s40942-019-0192-9 ◽

2019 ◽

Vol 5 (1) ◽

Cited By ~ 4

Author(s):

Felipe F. Conti ◽

Weilin Song ◽

Eduardo B. Rodrigues ◽

Rishi P. Singh

Keyword(s):

Vascular Endothelial Growth Factor ◽

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

Growth Factor ◽

Optical Coherence Tomography Angiography ◽

Vascular Endothelial ◽

Optical Coherence ◽

Anti Vegf ◽

Retinal Capillary ◽

Endothelial Growth Factor

Abstract Background Optical coherence tomography angiography (OCTA) enables detailed, non-invasive assessment of ocular vasculature. This study uses OCTA imaging to evaluate choriocapillaris and retinal capillary perfusion density (CPD) changes in diabetic retinopathy following anti-vascular endothelial growth factor (VEGF) treatment. Methods Records of 38 eyes at a single institution were reviewed, grouped as non-diabetic controls (19 eyes), diabetes mellitus patients with diabetic retinopathy (DR, 19 eyes) and macular edema (DME). DR eyes were imaged at baseline, 6-months and 12-months after anti-VEGF treatment. Quantitative analyses assessed CPD of the choriocapillaris and retinal plexus. Results DR eyes showed decreased choriocapillaris whole-image CPD (62.6 ± 6.1 vs. 68.4 ± 5.1, p < 0.003), foveal CPD (61.2 ± 7.4 vs. 66.3 ± 9.8, p < 0.014), and parafoveal CPD (61.9 ± 6.6 vs. 68.2 ± 4.8, p < 0.002) at baseline. DR eyes also showed decreased retinal density, including whole-image CPD (46.9 ± 5.1 vs. 50.7 ± 5.6, p < 0.04), foveal CPD (27.6 ± 5.9 vs. 34.1 ± 6.1, p < 0.002), and parafoveal CPD (49.0 ± 5.6 vs. 53.1 ± 6.0, p < 0.011). Following 12 months of anti-VEGF treatment, no changes to retinal or choriocapillaris or CPD were observed. Retinal central subfield thickness decreased (397.1 ± 93.2 µm vs. 294.2 ± 71.5 µm, p < 0.005). Lastly, FAZ area (0.307 ± 0.133 mm2 vs. 0.184 ± 0.058 mm2, p = 0.008) and perimeter (2.415 ± 0.692 mm2 vs. 1.753 ± 0.408 mm2, p = 0.002) were increased in DR eyes at baseline. No changes to FAZ area or perimeter were seen with anti-VEGF treatment in DR eyes. Conclusions Compared to control, choriocapillaris and retinal CPD are reduced in DR, while FAZ area and perimeter are increased. No retinal capillary or choriocapillaris CPD changes were observed in DR eyes following anti-VEGF treatment.

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