PURPOSE: To use optical coherence tomography angiography (OCTA) derived quantitative metrics to assess the response of choroidal neovascularization to pro-re-nata (PRN) anti-endothelial growth factor (anti-VEGF) treatment in neovascular age-related macular degeneration (AMD). DESIGN: Prospective longitudinal cohort study. PARTICIPANTS: Fourteen eyes from 14 study participants with treatment-naïve neovascular AMD were enrolled. METHODS: Subjects were evaluated monthly and treated with intravitreal anti-VEGF agents under a PRN protocol for one year. At each visit, two 3×3 mm2 OCTA scans were obtained. Custom image processing was applied to segment the outer retinal slab, suppress projection artifact, and automatically detect CNV. CNV membrane area (mm2) and CNV vessel area (mm2) was calculated. MAIN OUTCOMES: Individual and mean CNV membrane area and CNV vessel area at each visit; within-visit repeatability determined by coefficient of variation. RESULTS: Eight eyes had entire CNV within 3×3 mm2 scanning area and had adequate image quality for CNV quantification. One case (case #2) was excluded from analysis due to the presence of a large subretinal hemorrhage overlying the CNV membrane. In the remaining cases, CNV vessel area was reduced by 39%, 50%, 43%, and 41% at months 1, 3, 6, and 12 respectively. CNV membrane area was reduced by 39%, 51%, 54%, and 45% at months 1, 3, 6, and 12. At month 6, mean change from baseline was not statistically significant for CNV vessel area, while it was statistically significant for CNV membrane area. Neither metric was significantly different compared to baseline at month 12. Individual analyses revealed each CNV had a unique response under PRN treatment. Within-visit repeatability was was 7.96% (coefficient of variation) for CNV vessel area and 7.37% for CNV membrane area. CONCLUSIONS: In this small exploratory study of CNV response to PRN anti-VEGF treatment, both CNV vessel area and membrane area were reduced compared to baseline after three months. After one year of follow-up, these reductions were no longer statistically significant. When anti-VEGF treatment was held, increasing CNV vessel area over time often resulted in exudation, but it was not possible to exactly when exudation occurs.
PURPOSE: To use optical coherence tomography angiography (OCTA) derived quantitative metrics to assess the response of choroidal neovascularization to pro-re-nata (PRN) anti-endothelial growth factor (anti-VEGF) treatment in neovascular age-related macular degeneration (AMD). DESIGN: Prospective longitudinal cohort study. PARTICIPANTS: Fourteen eyes from 14 study participants with treatment-naïve neovascular AMD were enrolled. METHODS: Subjects were evaluated monthly and treated with intravitreal anti-VEGF agents under a PRN protocol for one year. At each visit, two 3×3 mm2 OCTA scans were obtained. Custom image processing was applied to segment the outer retinal slab, suppress projection artifact, and automatically detect CNV. CNV membrane area (mm2) and CNV vessel area (mm2) was calculated. MAIN OUTCOMES: Individual and mean CNV membrane area and CNV vessel area at each visit; within-visit repeatability determined by coefficient of variation. RESULTS: Eight eyes had entire CNV within 3×3 mm2 scanning area and had adequate image quality for CNV quantification. One case (case #2) was excluded from analysis due to the presence of a large subretinal hemorrhage overlying the CNV membrane. In the remaining cases, CNV vessel area was reduced by 39%, 50%, 43%, and 41% at months 1, 3, 6, and 12 respectively. CNV membrane area was reduced by 39%, 51%, 54%, and 45% at months 1, 3, 6, and 12. At month 6, mean change from baseline was not statistically significant for CNV vessel area, while it was statistically significant for CNV membrane area. Neither metric was significantly different compared to baseline at month 12. Individual analyses revealed each CNV had a unique response under PRN treatment. Within-visit repeatability was was 7.96% (coefficient of variation) for CNV vessel area and 7.37% for CNV membrane area. CONCLUSIONS: In this small exploratory study of CNV response to PRN anti-VEGF treatment, both CNV vessel area and membrane area were reduced compared to baseline after three months. After one year of follow-up, these reductions were no longer statistically significant. When anti-VEGF treatment was held, increasing CNV vessel area over time often resulted in exudation, but it was not possible to exactly when exudation occurs.
Authors: Yali Jia; Steven T Bailey; Thomas S Hwang; Scott M McClintic; Simon S Gao; Mark E Pennesi; Christina J Flaxel; Andreas K Lauer; David J Wilson; Joachim Hornegger; James G Fujimoto; David Huang Journal: Proc Natl Acad Sci U S A Date: 2015-04-20 Impact factor: 11.205
Authors: Eric Moult; WooJhon Choi; Nadia K Waheed; Mehreen Adhi; ByungKun Lee; Chen D Lu; Vijaysekhar Jayaraman; Benjamin Potsaid; Philip J Rosenfeld; Jay S Duker; James G Fujimoto Journal: Ophthalmic Surg Lasers Imaging Retina Date: 2014 Nov-Dec Impact factor: 1.300
Authors: Ryan B Rush; Sloan W Rush; Antonio V Aragon; J Edward Ysasaga Journal: Ophthalmic Surg Lasers Imaging Retina Date: 2015 Jul-Aug Impact factor: 1.300
Authors: Nils F Mokwa; Tina Ristau; Pearse A Keane; Bernd Kirchhof; Srinivas R Sadda; Sandra Liakopoulos Journal: J Ophthalmol Date: 2013-05-08 Impact factor: 1.909
Authors: Ahmed M Hagag; Jie Wang; Kevin Lu; Gareth Harman; Richard G Weleber; David Huang; Paul Yang; Mark E Pennesi; Yali Jia Journal: Am J Ophthalmol Date: 2019-03-06 Impact factor: 5.258
Authors: Henrik Faatz; Marie-Louise Gunnemann; Kai Rothaus; Marius Book; Matthias Gutfleisch; Albrecht Lommatzsch; Daniel Pauleikhoff Journal: Ophthalmologe Date: 2021-02 Impact factor: 1.059
Authors: Ahmed M Hagag; Shruti Chandra; Hagar Khalid; Ali Lamin; Pearse A Keane; Andrew J Lotery; Sobha Sivaprasad Journal: J Clin Med Date: 2020-06-21 Impact factor: 4.241
Authors: Tristan T Hormel; Yali Jia; Yifan Jian; Thomas S Hwang; Steven T Bailey; Mark E Pennesi; David J Wilson; John C Morrison; David Huang Journal: Prog Retin Eye Res Date: 2020-07-24 Impact factor: 21.198
Authors: Henrik Faatz; Marie-Louise Farecki; Kai Rothaus; Matthias Gutfleisch; Daniel Pauleikhoff; Albrecht Lommatzsch Journal: BMJ Open Ophthalmol Date: 2019-12-10