Clinical Ophthalmology (Dec 2023)

Characterizing Macular Neovascularization in Myopic Macular Degeneration and Age-Related Macular Degeneration Using Swept Source OCTA

  • Sayah DN,
  • Garg I,
  • Katz R,
  • Zhu Y,
  • Cui Y,
  • Zeng R,
  • Tandias R,
  • Moon JY,
  • Vingopoulos F,
  • Wescott HE,
  • Baldwin G,
  • Wang K,
  • Elze T,
  • Ludwig CA,
  • Vavvas DG,
  • Miller JW,
  • Husain D,
  • Kim LA,
  • Patel NA,
  • Miller JB

Journal volume & issue
Vol. Volume 17
pp. 3855 – 3866

Abstract

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Diane N Sayah,1– 3 Itika Garg,1,2 Raviv Katz,1,2 Ying Zhu,1,4 Ying Cui,1,5 Rebecca Zeng,1,2 Rachel Tandias,1,2 Jade Y Moon,1,2 Filippos Vingopoulos,1,2 Hannah E Wescott,1,2 Grace Baldwin,1,2 Kira Wang,1,2 Tobias Elze,1,2 Cassie Ann Ludwig,1,2 Demetrios G Vavvas,1,2 Joan W Miller,1,2 Deeba Husain,1,2 Leo A Kim,1,2 Nimesh A Patel,1,2 John B Miller1,2 1Harvard Retinal Imaging Lab, Boston, MA, USA; 2Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA; 3College of Optometry, University of Houston, Houston, TX, USA; 4Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 5Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People’s Republic of ChinaCorrespondence: John B Miller, Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, 243 Charles St, Boston, MA, 02114, USA, Tel +1 617 573-3750, Fax + 1 617 573-3698, Email [email protected]: Visual prognosis and treatment burden for macular neovascularization (MNV) can differ between myopic macular degeneration (MMD) and age-related macular degeneration (AMD). We describe and compare MNV associated with MMD and AMD using swept-source (SS)-OCTA.Patients and Methods: Adult patients with documented MNV associated with MMD or AMD were consecutively recruited. Qualitative and quantitative features were assessed from 6x6mm angiograms, including the MNV area and vessel density (VD). Descriptive statistics and linear regression analyses were carried out.Results: Out of 75 enrolled eyes with diagnosed MNV (30 MMD-MNV and 45 AMD-MNV; mean age 55± 19 and 75± 8 years, respectively), 44 eyes had discernible MNV (11 MMD-MNV and 33 AMD-MNV) on SS-OCTA at the time of the study and were included in the analysis. The MMD-MNV group exhibited a three-fold smaller sized MNV (p=0.001), lower greatest linear dimension (p=0.009) and greatest vascular caliber (p 0.05) between both conditions. After adjustment, decreased MNV area and increased VD were associated with the tree-in-bud pattern, whereas the diagnosis did not significantly influence those parameters.Conclusion: While larger studies are warranted, this study is the first to describe and compare MMD-MNV and AMD-MNV using SS-OCTA, providing relevant clinical insight on MNV secondary to MMD and AMD. These findings also further validate OCTA as a powerful tool to detect and characterize MNV non-invasively.Keywords: macular neovascularization, age-related macular degeneration, high myopia, swept source, OCT angiography

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