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Long-term Progression of Type 1 Neovascularization in Age-related Macular Degeneration Using Optical Coherence Tomography Angiography.

Abstract：

PURPOSE:To analyze the long-term growth patterns of type 1 neovascularization (NV) in eyes with age-related macular degeneration (AMD) receiving anti-vascular endothelial growth factor (VEGF) therapy. DESIGN:Retrospective cohort study. METHODS:Patients were enrolled from 2 eye centers and underwent optical coherence tomography angiography (OCTA) imaging with follow-up greater than 1 year. Choroidal neovascularization (CNV) was manually segmented on OCTA images and compared between time points. CNV growth was subdivided into 3 categories based on OCTA area measurement: CNV doubling, modest growth of less than 50%, and shrinkage. These growth rates were correlated with OCTA morphologic features. RESULTS:Forty-one eyes were analyzed. Mean CNV area was 1.60 ± 1.84 mm2 at baseline and 1.80 ± 1.84 mm2 at 1 year. Thirty-three eyes (80%) displayed an increase in CNV area at 1 year with a mean increase of 0.20 ± 0.38 mm2 (P = .001). Eleven eyes (27%) underwent CNV doubling, 19 eyes (46%) illustrated modest growth, and 6 (15%) showed shrinkage. Anatomic features including a capillary fringe (odds ratio [OR] = 5.3, P = .036) and immature lesion morphology (OR = 4.2, P = .015) were significantly associated with CNV doubling. CNV growth occurred in 3 predominant patterns: "symmetric" growth, "asymmetric" growth, and "finger-like projections," which reflected the orientation of expansion of CNV. "Symmetric" and "asymmetric" growth together correlated with greater frequency of CNV doubling (OR = 15, P = .0048). CONCLUSION:OCTA provides noninvasive measurement of the area of neovascular lesions in AMD. Sustained growth of type 1 NV can be identified in the majority of lesions (80%) that display characteristic patterns of progression despite ongoing anti-VEGF therapy.

journal_name

Am J Ophthalmol

journal_title

American journal of ophthalmology

authors

Xu D,Dávila JP,Rahimi M,Rebhun CB,Alibhai AY,Waheed NK,Sarraf D

doi

10.1016/j.ajo.2017.12.005

subject

Has Abstract

pub_date

2018-03-01 00:00:00

pages

10-20

eissn

0002-9394

issn

1879-1891

pii

S0002-9394(17)30534-2

journal_volume

187

pub_type

杂志文章,多中心研究

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Long-term Progression of Type 1 Neovascularization in Age-related Macular Degeneration Using Optical Coherence Tomography Angiography.