scholarly journals Macular density alterations in myopic choroidal neovascularization and the effect of anti-VEGF on it

2021 ◽  
Vol 14 (8) ◽  
pp. 1205-1212
Author(s):  
Jian-Bo Mao ◽  
◽  
Jia-Feng Yu ◽  
Xin-Yi Deng ◽  
Chen-Yi Liu ◽  
...  
Keyword(s):  
Choroidal Neovascularization ◽  
Capillary Density ◽  
Normal Group ◽  
Reduction Ratio ◽  
Vessel Density ◽  
Lesion Area ◽  
Flow Area ◽  
Myopic Choroidal Neovascularization ◽  
Anti Vegf ◽  
The Mean

AIM: To analyse macular microvascular alterations in myopic choroidal neovascularization (mCNV) and the efficiency of anti-vascular endothelial growth factor (anti-VEGF) therapy for mCNV by optical coherence tomography angiography (OCTA). METHODS: A total of 123 patients were included in this retrospective study, divided into mCNV group, high myopia (HM) group, and normal group at the Affiliated Eye Hospital of Wenzhou Medical University from January 2017 to January 2019. Superficial vessel density, deep capillary density, foveal avascular zone (FAZ) area, A-circularity index (AI) and vessel density around the 300 μm width of the FAZ region density (FD) and the area of choroidal neovascularization (CNV) lesion (only for mCNV group) were measured on 3×3 mm2 OCTA images. FAZ area was corrected for axial length. Central macular thickness (CMT) was measured on OCT in mCNV group. Compared the parameters on OCTA of 3 groups and pre-anti-VEGF and post-anti-VEGF at 1, 2, 3, and 6mo follow-up in mCNV group. RESULTS: There were significant differences among 3 groups in superficial vessel density, deep capillary density and FD (P<0.05). FAZ area in HM group was smaller than normal group (P<0.05), but there was no significant difference between mCNV group and the other two group. AI increased in mCNV group (P<0.05). The mean CMT, area and flow area of CNV lesion decreased after treatment (P<0.05), while vessel density and FAZ didn’t change. The mean CMT, area and flow area of CNV lesion statistically decreased after anti-VEGF treatment in mCNV group (P<0.05), while superficial vessel density, deep capillary density and FAZ area, AI and FD didn’t change. The mean reduction ratio of lesions was 50.32% (7.07% to 100%). Lesion regression 100% was observed in 2 cases (4.88%). There was a negative correlation between the CNV lesion area and reduction ratio (r=-0.380, P=0.042) and the flow lesion area and reduction ratio (r=-0.402, P=0.030). CONCLUSION: Macular vessel density decreases, FAZ turns smaller and more irregular in mCNV eyes. Anti-VEGF therapy is efficient for mCNV without affecting vessel density and FAZ, but it is unable to completely eliminate CNV lesions in most cases. The bigger mCNV lesions have lower reduction ratio.

scholarly journals Optical coherence tomography angiography of myopic choroidal neovascularization treated by anti-VEGF therapy

2019 ◽  
Author(s):  
Jianbo Mao ◽  
Yirun Shao ◽  
Chenyi Liu ◽  
Caiyun Zhang ◽  
Yiqi Chen ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Choroidal Neovascularization ◽  
Optical Coherence Tomography Angiography ◽  
Reduction Ratio ◽  
Vessel Density ◽  
Lesion Area ◽  
Flow Area ◽  
Anti Vegf ◽  
The Mean ◽  
Myopic Cnv

Abstract Background: To analyze the efficiency of anti-vascular endothelial growth factor (anti-VEGF) therapy for myopic choroidal neovascularization (CNV) by optical coherence tomography angiography (OCTA) and to determine the reduction ratio of CNV lesions after anti-VEGF therapy. Methods: A total of 41 patients (41 eyes) with myopic CNV who were treated with anti-VEGF were included in the study. The best corrected visual acuity (BCVA), superficial vessel density, deep vessel density, the area of foveal avascular zone (FAZ), central macular thickness (CMT) and the area and the flow area of CNV lesion at baseline and at the follow-up after 1, 2, 3 and 6 months were measured. Results: After treatment, BCVA improved (F=6.848, P<0.05), while the CMT (F=2.489, P<0.05), the area (F=3.125, P<0.05) and the flow area (F=3.558, P<0.05) of CNV lesion reduced. On the other hand, superficial vessel density, deep vessel density and the area of FAZ had no change. The mean reduction ratio of lesions was 50.32% (7.07% to 100%). Only in two cases, 100% lesion regression was observed (4.88%). There was a negative correlation between the CNV lesion area and reduction ratio (r=–0.380，P=0.042) and the flow lesion area and reduction ratio (r=–0.402, P=0.030). Conclusions: Anti-VEGF therapy is efficient for myopic CNV without affecting superficial vessel density and deep vessel density of retina, but it is unable to completely eliminate CNV lesions in most cases. The mean reduction ratio is 50.32%, and the bigger myopic CNV lesions have a lower reduction ratio.

scholarly journals Hyperreflective Material in Optical Coherence Tomography Images of Eyes with Myopic Choroidal Neovascularization May Affect the Visual Outcome

2020 ◽  
Vol 9 (8) ◽  
pp. 2394
Author(s):  
Yasuaki Mushiga ◽  
Sakiko Minami ◽  
Atsuro Uchida ◽  
Norihiro Nagai ◽  
Misa Suzuki ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Choroidal Neovascularization ◽  
Initial Treatment ◽  
Visual Outcome ◽  
Optical Coherence ◽  
Myopic Choroidal Neovascularization ◽  
Anti Vegf ◽  
The Mean ◽  
Better Than ◽  
Myopic Cnv

The visual outcome of myopic choroidal neovascularization (CNV) after anti-vascular endothelial growth factor (anti-VEGF) therapy varies among individuals. We retrospectively analyzed the data of 24 eyes (24 patients) with treatment-naïve myopic CNV who underwent anti-VEGF monotherapy following a pro-re-nata regimen at the Division of Medical Retina Clinic, Department of Ophthalmology, Keio University Hospital between May 2014 and December 2017. The mean age was 70.6 ± 2.1 years, and 16 (66.7%) patients were female. Overall, the mean best-corrected visual acuity (BCVA) improved (p = 0.034), and the mean height of the hyperreflective material (HRM), involving the CNV lesion recorded by optical coherence tomography, decreased (p < 0.01) 12 months after the initial treatment. Fifteen eyes (62.5%) achieved a BCVA of better than 0.10 in LogMAR at 12 months; they had a better BCVA (p = 0.015) and lower HRM intensity (p = 0.033) at baseline than the others. Remarkably, the BCVA improved (p < 0.05) and the HRM height (p < 0.01) decreased only in eyes with a final BCVA better than 0.10 as early as 1 month after the initial treatment, which was still present at 12 months. The HRM height and intensity, not only the BCVA, would be valuable in evaluating the prognosis of myopic CNV after anti-VEGF therapy, although further study is required.

Intravitreal Anti-VEGF Treatment of Myopic Choroidal Neovascularization

2017 ◽  
Vol 1 (2) ◽  
pp. 109-115
Author(s):  
Daniel R. Moroz ◽  
Monique Munro ◽  
Michael P. Fielden
Keyword(s):  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Age Related Macular Degeneration ◽  
Myopic Choroidal Neovascularization ◽  
Anti Vegf ◽  
Age Related ◽  
Significant Difference ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Purpose: To determine whether the presenting clinical features of active myopic choroidal neovascularization (CNV), including the presence of fibrosis or atrophy, limit the ultimate visual acuity gains from intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy. Methods: A retrospective analysis of 42 eyes with new-onset subfoveal CNV was performed. Only patients without concurrent age-related macular degeneration and with a spherical equivalent of at least −6.0 diopters were included in the study. All eyes received either intravitreal ranibizumab or bevacizumab injections as the primary treatment on a pro re nata basis for 1 year. Changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were recorded. Results: The mean number of ranibizumab (18 eyes) or bevacizumab (24 eyes) injections was 4.7 ± 0.5 over a mean follow-up time of 12 ± 0.4 months. The mean age of the patients was 62 ± 2.0 years. Based on optical coherence tomography staging at the initiation of treatment for active CNV, 30 had no fibrosis or atrophy (group 1), 5 had fibrotic stage, and 7 had atrophic stage CNV (the latter combined to form group 2). The BCVA for group 1 improved significantly ( P < .02) but worsened for group 2 ( P < .38), a statistically significant difference ( P < .05). The CRT for group 1 also declined significantly more than for group 2 ( P < .014). Conclusion: The presence of fibrosis or atrophy in eyes with active myopic CNV at the initiation of anti-VEGF therapy was associated with limited anatomic outcomes and visual gain.

scholarly journals Relationship between retinal capillary vessel density of OCT angiography and intraocular pressure in pig

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mihyun Choi ◽  
Seong-Woo Kim ◽  
Somin Ahn ◽  
Thi Que Anh Vu ◽  
Cheolmin Yun ◽  
...  
Keyword(s):  
Capillary Density ◽  
Vessel Density ◽  
Retinal Blood Flow ◽  
Vascular Plexus ◽  
Retinal Capillary ◽  
Capillary Plexus ◽  
Ocular Pressure ◽  
Retinal Artery ◽  
The Mean ◽  
Iop Elevation

AbstractThe purpose of this study was to evaluate density change in the retinal capillary plexus during intra ocular pressure (IOP) elevation in vitrectomized pigs’ eyes using optical coherence tomography angiography (OCTA). Eight eyes of eight micro pigs received vitrectomy and the IOP was controlled from 15 mmHg (baseline) to 105 mmHg in 15 mmHg increments using a vented-gas forced-infusion system, and then decreased back to normal IOP (recovery state). The spectral-domain OCTA device was set to scan an area of 8.8 × 4.4 mm (30° × 15°) above the optic nerve head for each IOP. The relative vessel density (rVAD) compared to baseline was determined for the total retinal blood flow (RBF) which included major retinal artery and venous vessels, radial peripapillary capillaries (RPCs), superficial (SVP), intermediate (IVP), and deep vascular plexus (DVP). The mean rVAD was 0.890 in RBF, 0.826 in RPCs, 0.817 in SVP, 0.819 in IVP, and 0.794 in DVP at 30 mmHg. While the rVAD of RBF and RPCs decreased to 0.504 and 0.541 at 45 mmHg, the SVP, IVP, and DVP decreased to 0.433, 0.359, and 0.345, respectively. When IOP was normalized, the rVAD was recovered in all layers and the VAD of RBF, IVP, and DVP were higher than baseline (P = 0.040, 0.019, and 0.019, respectively). Retinal capillary density deterioration in each layer was found from 30 mmHg using an OCTA system which showed excellent depth-resolved segmentation of retinal capillary layers even at higher IOPs. Reduction in VAD showed full recovery after IOP normalization.

Anti-VEGF Therapy in Myopic Choroidal Neovascularization: Long-Term Results

2014 ◽  
Vol 232 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Paulo Freitas-da-Costa ◽  
João Pinheiro-Costa ◽  
Beatriz Carvalho ◽  
Manuel Falcão ◽  
Elisete Brandão ◽  
...  
Keyword(s):  
Choroidal Neovascularization ◽  
Long Term Results ◽  
Myopic Choroidal Neovascularization ◽  
Anti Vegf

scholarly journals Type 1 Choroidal Neovascularization Evolution by Optical Coherence Tomography Angiography: Long-Term Follow-Up

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Marco Rispoli ◽  
Maria Cristina Savastano ◽  
Bruno Lumbroso ◽  
Lisa Toto ◽  
Luca Di Antonio
Keyword(s):  
Optical Coherence Tomography ◽  
Choroidal Neovascularization ◽  
Structural Changes ◽  
Imaging Techniques ◽  
Optical Coherence ◽  
Anti Vegf ◽  
The Mean

Purpose. To evaluate structural changes in response to antivascular endothelial growth factor (anti-VEGF) treatment in patients with long-term type 1 choroidal neovascularization (CNV) by optical coherence tomography (OCT) and OCT angiography (OCTA). Method. This is a longitudinal study that involved a total of 51 eyes with type 1 CNV (35 female and 16 male eyes). Structural OCT and OCTA were performed on all the subjects. AngioVue OCTA (XR Avanti, Optovue, Inc., Fremont, CA) was used to obtain qualitative and quantitative information. All eyes were treated with an anti-VEGF ProReNata (PRN) approach and were followed for a mean of 38.9 months (SD±7.22). Best-corrected visual acuity (BCVA) was assessed at each follow-up timepoint. Results. We observed two kinds of possible evolution of type 1 CNV: “positive evolution,” including stabilization in 20% of patients and chronicity in 35%, and “negative evolution,” in which fibrosis was shown in 18% of patients, chorioretinal atrophy in 25%, and hemorrhage or RPE tears in 2%. The mean BCVA at baseline was 33.67±15.85 ETDRS letters; after 1 and 2 years, it was 31.61±18.04 and 31.18±18.58 ETDRS letters, respectively. The mean BCVA at the end of follow-up was 25.27±20 ETDRS letters. The difference between the values at baseline and at the end of follow-up was not statistically significant (P=0.06, r2=0.10). Conclusions. This study describes an in vivo structural long-term evolution of type 1 CNV by OCT and OCTA. Different possible CNV outcomes were observed. This study suggests that new retinal imaging techniques could be useful tools for assessing the potential retinal changes in the evolution of type 1 CNV to develop personalized medicine. Further studies using OCTA in the long term are needed to better understand why similarly treated type 1 CNV cases evolve differently and produce different results.

Management of Myopic Choroidal Neovascularization: Focus on Anti-VEGF Therapy

Drugs ◽  
2016 ◽  
Vol 76 (11) ◽  
pp. 1119-1133 ◽  
Author(s):  
Kelvin Yi Chong Teo ◽  
Wei Yan Ng ◽  
Shu Yen Lee ◽  
Chui Ming Gemmy Cheung
Keyword(s):  
Choroidal Neovascularization ◽  
Myopic Choroidal Neovascularization ◽  
Anti Vegf

scholarly journals Focal choroidal excavation complicated with choroidal neovascularization in young and middle aged patients

2018 ◽  
Author(s):  
Wenyi Tang ◽  
Ting Zhang ◽  
Qinmeng Shu ◽  
Chunhui Jiang ◽  
Qing Chang ◽  
...  
Keyword(s):  
Choroidal Neovascularization ◽  
Retinal Thickness ◽  
Young Patients ◽  
Central Retinal Thickness ◽  
Middle Aged ◽  
Aged Patients ◽  
Focal Choroidal Excavation ◽  
Anti Vegf ◽  
Mean Width ◽  
The Mean

Abstract Background To investigate the clinical and optical coherence tomography (OCT) features of focal choroidal excavation (FCE) complicated with choroidal neovascularization (CNV) in young and middle aged patients. Methods We performed a retrospective review of 26 patients with FCE accompanied by CNV. All patients underwent a complete ophthalmic examination. We analyzed the clinical characteristics of patients, focusing on the spectral-domain OCT features. All patients received intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) agents. And we assessed the changes of central retinal thickness and best-corrected visual acuity (BCVA) after anti-VEGF therapy. Results The mean age of 26 patients was 35.5 ± 7.3 years (range, 21 - 48 years). Of the 26 FCE lesions, 11 were located subfoveally, 6 were parafoveal, and 9 were extrafoveal. The mean FCE depth was 129.8 ± 50.3 μm, and the mean width was 901.3 ± 306.0 μm. The FCE depth was correlated positively with the width, but not correlated with age or refractive error. CNV was located within the excavation (19 eyes) or adjacent to the excavation (7 eyes). After anti-VEGF therapy, the central retinal thickness was significantly reduced and the BCVA was significantly improved. In the absorption process of subretinal fluid, we found that the fluid in the excavations needed to be absorbed at the last. A small amount of residual fluid could still be seen in a few deep excavations even after a long-term follow-up. Conclusions FCE may be an important reason to cause CNV. Especially in young patients with idiopathic CNV, we should pay attention to the use of OCT to check the presence of FCE. Anti-VEGF therapy is generally effective for CNV associated with FCE.

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