EFFECTS OF VEGF INHIBITION ON RETINAL MORPHOLOGY, NEOVASCULAR NETWORK SIZE, AND VISUAL ACUITY IN PATIENTS WITH VASCULARIZED PIGMENT EPITHELIUM DETACHMENT BECAUSE OF OCCULT CHOROIDAL NEOVASCULARIZATION

Purpose of the study is to determine the reliability of OCT angiography in the diagnosis of type 1 choroidal neovascularization (CNV) in wet age-related macular degeneration depending on the height of pigment epithelium detachment (PED).Material and methods. The study included 82 patients (114 eyes) with confirmed type 1 CNV, who were examined using spectral OCT and OCTA. The patients were divided into two groups depending on PED height: group 1 consisted of 69 eyes with PED height less than 300 μm, while group 2 (45 eyes) had PED height of more than 300 μm. A separate comparative analysis of the visualization of pathological vessels was made in a group of untreated patients (56 eyes) and a group of patients (58 eyes) treated with angiogenesis inhibitors.Results. In group 1 with a PED height less than 300 μm (167.0 ± 60.4 μm) OCTA detected blood flow along abnormal vessels in 100 % of cases. In group 2 with a PED height above 300 μm (484.7 ± 131.9 μm) CNV vessels were visualized in 24.4 % of eyes. The PED height of patients after intravitreal injections of angiogenesis inhibitors (IVI IA) ranged from 38 to 683 μm (221 ± 133 μm). According to OCTA visualization of type 1 CNV vasculature was noted in 55 eyes (94.8 %). In patients who received no antiangiogenic therapy, with a PED height 59 - 800 μm (238 ± 149 μm) CNV was visualized in 41 % of cases (23 eyes).Conclusion. OCTA showed high reliability in the diagnosis of type 1 CNV with low PED. This method was significantly less informative when the height of the neovascular PED exceeded 300 μm, with the exception of PED after IVI IA.

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Pattern Dystrophies and Choroidal Neovascularization

Güncel Retina Dergisi (Current Retina Journal) ◽

10.37783/crj-0053 ◽

2017 ◽

pp. 313-320

Keyword(s):

Visual Acuity ◽

Choroidal Neovascularization ◽

Middle Ages ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Subretinal Fluid ◽

Age Related Macular Degeneration ◽

Pattern Dystrophy ◽

Good Visual Acuity ◽

Age Related

Pattern dystrophies are hereditary dystrophies that come from retinal pigment epithelium and located in the macula. The diagnosis is usually made around the middle ages. Pigment accumulations in the macula and around the macula, are seen bilaterally and symmetrical in the beginning, are sub-divided depending on pigment scattering pattern. These are adult-onset foveomacular vitelliform dystrophy, butterfly-like pattern dystrophy, reticular pattern dystrophy, and fundus pulverulentus. Usually in patients with pattern dystrophy have good visual acuity, after progression central visual acuity lessens with RPE atrophy or choroidal neovascularization development. In choroidal neovascularization secondary to age-related macular degeneration there is no typical pigmentation in the macula. On the other hand, in choroidal neovascularization related to pattern dystrophy, hemorrhage, and intra/subretinal fluid do not exist. Today choroidal neovascularization prognosis, which is treated with intravitreal anti-VEGF injections, is quite good. At least, one eye of the patients has satisfactory vision. Sometimes, in especially patients with isolated pattern dystrophy, not hereditary, there may be spontaneous regression of choroidal neovascularization.

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Long-Term Visual/Anatomic Outcome in Patients with Fovea-Involving Fibrovascular Pigment Epithelium Detachment Presenting Choroidal Neovascularization on Optical Coherence Tomography Angiography

Journal of Clinical Medicine ◽

10.3390/jcm9061863 ◽

2020 ◽

Vol 9 (6) ◽

pp. 1863 ◽

Cited By ~ 1

Author(s):

Kyung Tae Kim ◽

Hwanho Lee ◽

Jin Young Kim ◽

Suhwan Lee ◽

Ju Byung Chae ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Protective Effect ◽

Choroidal Neovascularization ◽

Optical Coherence Tomography Angiography ◽

Pigment Epithelium ◽

Optical Coherence ◽

Pigment Epithelium Detachment ◽

Anti Vegf ◽

Treat And Extend Regimen

Background: To evaluate long-term visual/anatomic outcome after anti-vascular endothelial growth factor (anti-VEGF) therapy in patients with fovea-involving fibrovascular pigment epithelium detachment (PED) presenting with choroidal neovascularization (CNV) on optical coherence tomography angiography (OCTA). Methods: Patients with fibrovascular PED or subretinal CNV confirmed by OCTA who were treated by a relaxed treat-and-extend regimen for 2 years were retrospectively reviewed. The best-corrected visual acuity (BCVA) and central subfield retinal thickness (CST) before and after anti-VEGF injection were analyzed. Furthermore, changes in photoreceptor layer (PRL) thickness and outer retinal bands in the fovea after injection were evaluated. Results: A total of 31 eyes with fibrovascular PED and 24 eyes with subretinal CNV were included. Following a relaxed treat-and-extend regimen with anti-VEGF agents, BCVA and CST were improved, and the PRL thickness was decreased significantly. There were no differences in BCVA, CST, changes in PRL thickness, or the status of outer retinal bands between the groups. However, the difference in the amount of decrease in PRL thickness between the two groups was increased at 2 years, and the slope tended to be steeper in the subretinal CNV group. Conclusions: Exudative age-related macular degeneration (AMD) with fibrovascular PED or subretinal CNV showed good visual/anatomic outcomes after anti-VEGF treatment, regardless of the CNV type. By 2 years, fibrovascular PED did not have an additional protective effect on the outer retina, compared with subretinal CNV over 2 years. Further follow-up study might be needed to conclude that fibrovascular PED has a protective effect on the surrounding photoreceptor area.

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Optical Coherence Tomography Prognostic Factors in AMD Patients with Peripapillary Choroidal Neovascularization

Ophthalmologica ◽

10.1159/000520930 ◽

2021 ◽

Author(s):

Gilad Rabina ◽

Anfisa Ayalon ◽

Michael Mimouni ◽

Nir Stanescu ◽

Elad Moisseiev ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Choroidal Neovascularization ◽

Pigment Epithelium ◽

Case Series ◽

Age Related Macular Degeneration ◽

Optical Coherence ◽

Foveal Thickness ◽

Age Related ◽

One Year

Purpose: To investigate the correlation between optical coherence tomography (OCT) findings and visual acuity outcomes after treatment with intravitreal bevacizumab (IVB) injections for age related macular degeneration (AMD) patients with peripapillary choroidal neovascularization (PPCNV). METHODS: A retrospective case series of consecutive patients diagnosed with PPCNV secondary to AMD. All patients were treated with IVB injections with a follow-up time of one year. Data collected included best corrected visual acuity (BCVA), automated and manually measured OCT parameters. RESULTS: A total of 68 eyes were diagnosed with PPMV. Of them, 30 eyes of 30 patients aged 84.3±6.9 years of which 63.3% female gender were included. Baseline BCVA was 0.46±0.62 logMAR (Snellen 20/57), average choroidal thickness was 193.2±22 µm and mean number of IVB injections was 7.2±1.9. After one year BCVA was 0.56±0.78 logMAR (Snellen 20/72) (p=0.28). Eyes with greater central retinal thickness (r=-0.36, p=0.05), greater subretinal hyperreflective material (SHRM) area (r=-0.37, p=0.05) and greater sub retinal fluid (SRF) area (r=-0.73, p<0.001) had a significantly smaller improvement in BCVA. Eyes with pigment epithelium detachment (PED) (0.68±0.90 versus 0.21±0.12, p=0.03) had a significantly worse BCVA. CONCLUSIONS: Our data suggests that AMD related PPCNV with greater foveal thickness, PED size, SHRM and SRF areas have worse final BCVA prognosis.

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