OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IMAGING OF CHOROIDAL NEOVASCULARIZATION SECONDARY TO CHOROIDAL RUPTURE TREATED BY INTRAVITREAL RANIBIZUMAB

The purpose was to demonstrate the diagnostic and therapeutic feasibility of swept source-optical coherence tomography angiography (SS-OCTA) by picturing neovascular changes secondary to a rare white dot syndrome following long-term intravitreal ranibizumab (IVR). A 28-year-old Caucasian myopic female presented with visual loss in her right eye only. The clinical examination and multimodal imaging including spectral domain (SD)-OCT, blue-peak autofluorescence, fluorescein, and indocyanine green angiography (HRA Spectralis, Heidelberg Engineering; Heidelberg, Germany) as well as SS-OCTA (DRI Triton, Topcon; Tokyo, Japan) led to the diagnosis of idiopathic punctate inner choroidopathy with secondary subfoveal choroidal neovascularization (CNV). In addition to oral corticosteroids, a pro re nata regimen with IVR was initiated and guided by repeated SD-OCT and SS-OCTA. Six IVR were administered based on functional SS-OCTA en face scans illustrating vessel transformation and downsizing of the CNV area while SD-OCT B-scans were inconclusive as indirect signs of activity were absent throughout the follow-up period. SS-OCTA provided new possibilities for monitoring vessel development. IVR was managed based on vessel density as displayed by SS-OCTA.

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Optical coherence tomography angiography in myopic choroidal neovascularization after intravitreal ranibizumab

European Journal of Ophthalmology ◽

10.1177/1120672118785495 ◽

2018 ◽

Vol 29 (2) ◽

pp. 239-243

Author(s):

Gilda Cennamo ◽

Francesca Amoroso ◽

Stefano Schiemer ◽

Nunzio Velotti ◽

Mariacristina Alfieri ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Choroidal Neovascularization ◽

Optical Coherence Tomography Angiography ◽

Pathologic Myopia ◽

Optical Coherence ◽

Intravitreal Ranibizumab ◽

Corrected Visual Acuity ◽

Best Corrected Visual Acuity

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.

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Optical Coherence Tomography Angiography Evolution of Choroidal Neovascular Membrane in Choroidal Rupture Managed by Intravitreal Bevacizumab

Case Reports in Ophthalmological Medicine ◽

10.1155/2019/5241573 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Massimo Lorusso ◽

Luisa Micelli Ferrari ◽

Eleni Nikolopoulou ◽

Tommaso Micelli Ferrari

Keyword(s):

Optical Coherence Tomography ◽

Choroidal Neovascularization ◽

Optical Coherence Tomography Angiography ◽

Anterior Segment ◽

Intravitreal Bevacizumab ◽

Optical Coherence ◽

Vascular Structure ◽

Choroidal Neovascular Membrane ◽

Choroidal Rupture

Purpose. To describe a case of a 25-year-old man with choroidal neovascularization (CNV) secondary to traumatic choroidal rupture treated with intravitreal bevacizumab and to evaluate the vascular structure of the area near the traumatic choroidal rupture. Methods. The patient underwent complete ophthalmologic evaluation, including best-corrected visual acuity (BCVA), intraocular pressure, anterior segment and funds examination, and optical coherence tomography angiography (OCTA) at baseline and on each follow-up visit. Fluorescein angiography (FA) was performed at baseline. Intravitreal bevacizumab was administered at the time of choroidal neovascular membrane diagnosis. Results. At baseline, ophthalmoscopic examination of the left eye revealed four subretinal macular hemorrhages and two choroidal ruptures located temporally to the fovea. On OCT angiograms, the choroidal rupture appeared as a hypointense break in choriocapillaris plexus. At 4-week follow-up, the OCTA disclosed a well circumscribed lesion characterized by numerous and fine anastomotic vessels. Patient received intravitreal injection of bevacizumab. At 6-week post injection, OCTA documented regression of the neovascular complex. Conclusion. Choroidal neovascularization is a common complication associated with traumatic choroidal rupture and OCTA may represent a complementary diagnostic technique to evaluate the vascular structure of the area near the traumatic choroidal rupture.

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Diagnostic value of optical coherence tomography angiography for choroidal neovascularization in age-related macular degeneration: A systematic review and meta-analysis

Ophthalmic Research ◽

10.1159/000511265 ◽

2020 ◽

Author(s):

Chang-Xi Chen ◽

Mei-Ling Liu ◽

Kai Cao ◽

Mayinuer Yusufu ◽

Jin-Da Wang

Keyword(s):

Systematic Review ◽

Optical Coherence Tomography ◽

Macular Degeneration ◽

Choroidal Neovascularization ◽

Optical Coherence Tomography Angiography ◽

Meta Analysis ◽

Diagnostic Value ◽

Age Related Macular Degeneration ◽

Optical Coherence ◽

Classification Rate

Objective: To evaluate the diagnostic value of optical coherence tomography angiography (OCTA) in detecting the choroidal neovascularization (CNV) in agerelated macular degeneration (AMD). Methods: A systematic review and meta-analysis was performed by searching Pubmed, Science Direct, Embase and Web of Science. The pooled sensitivity and specificity with 95% confidence intervals (CIs), area under the summary receiver operator characteristic curve (sROC), and the total accurate classification rate were used to evaluate OCTA’ diagnostic value of CNV in AMD patients. Results: Seven studies involving 517 eyes were included in the analysis. The mean age of subjects in each study ranged from 58.5 years to 81.7 years. Fluorescein angiography was applied as the gold standard in five studies. There were 350 eyes diagnosed with CNV, OCTA detected 301 eyes correctly, while among the 167 eyes without CNV, OCTA identified 150 correctly. The total accurate classification rate was 87.23%. The Spearman's rank correlation coefficient was 0.5, indicating that there was no significant threshold effect in the current study (S=8, p=0.103). The pooled sensitivity and pooled specificity were 0.89 (95%CI: 0.82,0.94) and 0.96 (95%CI: 0.85,1.00) respectively. The area under sROC was up to 0.911. Conclusion: The specificity of OCTA for the detection of CNV in AMD patients is extremely high, however, the sensitivity still needs to be improved. In general, the metaanalysis revealed that OCTA had a high diagnostic value for the detection of CNV in AMD patients.

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