Study of optical coherence tomography angiography for neovascular age-related macular degeneration

Abstract

AIM: To analyze the characteristics of choroidal neovascularization(CNV)in neovascular age-related macular degeneration(nARMD)patients and the outcome of intravitreal anti-vascular endothelial growth factor(VEGF)treatment by using optical coherence tomography angiography(OCTA). METHODS: A prospective cohort study was carried out, which included 37 eyes of 29 patients with nARMD in West China Hospital during May to December 2017. OCTA scans was conducted to all patients before treatment, 1d, 1wk, 1mo and 3-6mo after treatment. The analysis was performed to evaluate the morphological characteristics, lesion area, parafoveal superficial vessel density and perfusion area of CNV before and after treatment. RESULTS: Among all the subjects, immature structure, small branches, and capillaries responded well to anti-VEGF treatment. Compared with the mean lesion area in nARMD patients before treatment(1.27±1.88mm2), there was significant reduction(1.13±1.79 mm2)1d after treatment, which meant CNV lesion decreased 1d after treatment, and stabilized 1mo later(P=0.001). Obvious decrease was observed both in parafoveal superficial vessel density(P=0.003)and perfusion area(P=0.015)3mo after treatment in nARMD patients. CONCLUSION: OCTA, a non-invasive diagnostic examination, clearly identified tiny structures of CNV, quantified the lesion area and displayed specific vasculature in nARMD patients. Furthermore, retinal microcirculation can be detected using OCTA, which provides an effective approach of monitoring the progression and treatment effect of nARMD.

Keywords

• optical coherence tomography angiography
• neovascular age-related macular degeneration
• vascular endothelial growth factor
• choroidal neovascularization