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 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 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.

scholarly journals The Role of Optical Coherence Tomography Angiography in Moderate and Advanced Primary Open-Angle Glaucoma

2021 ◽  
Author(s):  
Yadollah Eslami ◽  
Sepideh Ghods ◽  
Massood Mohammadi ◽  
Mona Safizadeh ◽  
Ghasem Fakhraie ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Vessel Density ◽  
Mean Deviation ◽  
Optical Coherence ◽  
Open Angle ◽  
The Mean ◽  
Inferior Quadrant

Abstract Purpose: To evaluate the relationship between structure and function in moderate and advanced primary open-angle glaucoma (POAG) and to determine the accuracy of structure and vasculature for discriminating moderate from advanced POAG.Methods: In this cross-sectional study 25 eyes with moderate and 40 eyes with advanced POAG were enrolled. All eyes underwent measurement of the thickness of circumpapillary retinal nerve fiber layer (cpRNFL) and macular ganglion cell complex (GCC), and optical coherence tomography angiography (OCTA) of the optic nerve head (ONH) and macula. Visual field (VF) was evaluated by Swedish interactive threshold algorithm and 24-2 and 10-2 patterns. The correlation between structure and vasculature and the mean deviation (MD) of the VFs was evaluated by a partial correlation coefficient. The area under the receiver operating characteristic curve (AUC) was applied for assessing the power of variables for discrimination moderate from advanced POAG.Results: Superior cpRNFL, superior GCC, whole image vessel density (wiVD) of the ONH area, and vessel density in inferior quadrant of perifovea had the strongest correlation with the mean deviation (MD) of the VF 24-2 (r= .351, .558, .649 and .397; p< .05). The greatest AUCs belonged to inferior cpRNFL (.789), superior GCC (.818), vessel density of the inferior hemifield of ONH area (.886), and vessel density in inferior quadrant of perifovea (.833) without statistically significant difference in pairwise comparison.Conclusion: Vasculature has a stronger correlation than the structure with MD in moderate and advanced POAG and is as accurate as structure in discrimination moderate from advanced POAG.

scholarly journals The Role of Optical Coherence Tomography Angiography in Ranibizumab-Treated Choroidal Neovascularization in Choroidal Osteoma

2020 ◽  
Vol 11 (2) ◽  
pp. 370-376
Author(s):  
William J. Carroll ◽  
Yi Stephanie Zhang ◽  
Lee M. Jampol ◽  
Manjot K. Gill
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Optical Coherence Tomography Angiography ◽  
Initial Evaluation ◽  
Optical Coherence ◽  
Choroidal Osteoma ◽  
Anti Vegf ◽  
Subsequent Response ◽  
Intraretinal Fluid

In this study, we report the initial evaluation of choroidal neovascularization (CNV) secondary to choroidal osteoma and subsequent response to anti-vascular endothelial growth factor (anti-VEGF) treatment monitored with optical coherence tomography angiography (OCT-A). A 38-year-old female presented with an initial visual acuity of 20/150 in the left eye. Clinical examination revealed a choroidal osteoma. OCT demonstrated both subretinal and intraretinal fluid. OCT-A was performed and showed CNV. A course of ten treatments with ranibizumab showed an improvement of visual acuity to 20/30–3, improvement of subretinal and intraretinal fluid, as well as attenuation of CNV. Our report demonstrates OCT-A as a useful tool for both initial evaluation of CNV and following treatment response to anti-VEGF therapy.

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.

scholarly journals Result of intravitreal aflibercept injection for myopic choroidal neovascularization

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shih-Lin Chen ◽  
Pei-Ling Tang ◽  
Tsung-Tien Wu
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Choroidal Neovascularization ◽  
Optical Coherence ◽  
Foveal Thickness ◽  
Flow Area ◽  
Myopic Choroidal Neovascularization ◽  
Central Foveal Thickness ◽  
Intravitreal Aflibercept ◽  
Myopic Cnv

Abstract Background The current study aimed to evaluate the efficacy of intravitreal aflibercept injections as the primary treatment for subfoveal/juxtafoveal myopic choroidal neovascularization (CNV) by using optical coherence tomography (OCT). Optical coherence tomography angiography (OCTA) was further used for some patients to detect the changes of CNV after treatment. Methods In the present study, 21 treatment-naive eyes of 21 patients with subfoveal/juxtafoveal myopic CNV received primary intravitreal aflibercept injections and were under follow-up for a minimum duration of 12 months. Among the 21 patients, 12 underwent OCTA to evaluate the changes in central foveal thickness, selected CNV area, and flow area. Results The mean best-corrected visual acuity (BCVA) pertaining to all the patients significantly improved from the baseline value of 0.7 to 0.3 logMAR after treatment for 12 months (P = 0.001). However, the improvements in the median BCVA after treatment for three and 12 months were not statistically significant in the younger group (< 50 years), compared to the older group (≥ 50 years). One aflibercept injection resolved the CNV in 47.6% (10/21) of the patients. The younger group displayed greater improvement in the median central foveal thickness, compared to the older group. OCTA revealed interlacing or disorganized pattern at the level of the outer retinal layer in 12 subjects with myopic CNV. After 3 months of treatment, both groups displayed a decrease in the size of the selected CNV area and flow area. The interlacing group displayed a trend towards better anatomical improvements. Conclusion Intravitreal aflibercept injection provides long-term improvement in visual acuity in patients with myopic CNV. Eyes with the interlacing pattern on OCTA displayed a greater decrease in size and flow after aflibercept injection. Trial registration Before data collection, written informed consent was obtained from each participant, whose identity information was protected by encryption and conversion to a non-identifiable format and removing data links. This study was approved by the Institutional Review Board of Kaohsiung Veterans General Hospital (KSVGH21-CT1–17).

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

2020 ◽  
Vol 9 (6) ◽  
pp. 1863 ◽  
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.

Optical coherence tomography angiography of choroidal neovascularization in immune choroiditis following acute retinal necrosis

2020 ◽  
pp. 112067212097734
Author(s):  
Shun Nakamura ◽  
Shintaro Nakao ◽  
Satomi Shiose ◽  
Ri-ichiro Kohno ◽  
Eiichi Hasegawa ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Choroidal Neovascularization ◽  
Optical Coherence Tomography Angiography ◽  
Inflammatory Cells ◽  
Acute Retinal Necrosis ◽  
Optical Coherence ◽  
Outer Retina ◽  
Anti Vegf ◽  
The Right ◽  
Endothelial Growth Factor

Purpose: To report optical coherence tomography angiography (OCTA) findings in a case of immune choroiditis following contralateral acute retinal necrosis (ARN) with choroidal neovascularization (CNV) during anti-vascular endothelial growth factor (VEGF) therapy. Case report: A 64-year-old woman with immune choroiditis following contralateral ARN and secondary CNV presented with decreased visual acuity. Fundus examination revealed macular and peripheral yellowish lesions in the right eye. Inflammatory cells were observed in the anterior chamber and the vitreous. OCT revealed retinal exudative changes and subretinal lesions suggestive of CNV. OCTA detected an abnormal vascular net in the outer retina as well as choriocapillaris, corresponding to type 2 CNV, that reduced following intravitreous anti-VEGF therapy. Two weeks after treatment, OCTA showed re-dilated choroidal neovasculature at the outer retina despite no exudative recurrence in OCT. Six weeks after treatment, OCT detected exudative changes around the neovascular lesion. Conclusion: This case discusses the use of OCTA detection of CNV in a case of immune choroiditis following contralateral ARN. During anti-VEGF therapy for inflammatory CNV-related diseases, OCTA may be useful not only for CNV detection but also for the follow-up of CNV activity.

scholarly journals Role of Optical Coherence Tomography Angiography in Following-up Choroidal Neovascular Membranes during the Course of Aflibercept Therapy

2021 ◽  
pp. 89-96
Author(s):  
Ahmad R. Ziada ◽  
Mostafa Abd El Latif Abo El Einen ◽  
Hamdy Abd El Azim El Koumy ◽  
El Said Ibraheem El Dessouky
Keyword(s):  
Choroidal Neovascularization ◽  
Optical Coherence Tomography Angiography ◽  
University Hospital ◽  
P Value ◽  
Interventional Study ◽  
Flow Area ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Automated Software

Aims: To evaluate the mean area of choroidal neovascularization (CNV) and the flow area within the CNV and determine their value in monitoring the effect of aflibercept therapy. Study Design: prospective, interventional study. Place and Duration of Study: Tanta University Hospital in the period between March 2017 and March 2019. Methodology: OCT angiography images were obtained using the AngioVue (Optovue Inc., CA, USA). For quantitative analysis of the mean area of CNV and the flow area within the CNV, the CNV was manually delineated with the help of the manufacturer’s automated software, and the parameters of interest were automatically calculated and generated. Results: The study included forty eyes of 40 patients, 14 females and 26 males, the mean age of patients was 69 ± 5 years. The mean baseline best-corrected visual acuity (BCVA) was 51.29 ± 14.80 ETDRS letters, which significantly increased to 63.41 ± 5.03 at week 36; p-value < 0.05. The mean area of choroidal neovascularization decreased significantly from baseline (2.72 ± 4.29 mm2) to week 36 (1.53 ± 1.07 mm2); p-value < 0.05. The the flow area within the measured CNV decreased significantly from baseline (2.28 ± 2.08 mm2) to week 36 (0.91 ± 0.63 mm2); p-value < 0.05. Conclusion: The mean area of CNV and the flow area within the measured CNV are valuable biomarkers for following up CNV during treatment with aflibercept.

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