Kelvin Yi Chong Teo1, Yasuo Yanagi2, Tien Yin Wong3, Usha Charkaravarty4, Chui Ming Gemmy Cheung5. 1. Medical Retina Department, Singapore National Eye Centre, Singapore, Republic of Singapore; Retina Research Group, Singapore Eye Research Institute, Singapore, Republic of Singapore; Save Sight Institute, University of Sydney, Camperdown, Australia. 2. Medical Retina Department, Singapore National Eye Centre, Singapore, Republic of Singapore; Retina Research Group, Singapore Eye Research Institute, Singapore, Republic of Singapore. 3. Medical Retina Department, Singapore National Eye Centre, Singapore, Republic of Singapore; Retina Research Group, Singapore Eye Research Institute, Singapore, Republic of Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore; Ophthalmology Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore, Republic of Singapore. 4. School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, United Kingdom. 5. Medical Retina Department, Singapore National Eye Centre, Singapore, Republic of Singapore; Retina Research Group, Singapore Eye Research Institute, Singapore, Republic of Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore; Ophthalmology Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore, Republic of Singapore. Electronic address: gemmy.cheung.c.m@snec.com.sg.
Abstract
PURPOSE: To describe the systemic and ocular features of fellow eyes' association with nonexudative neovascularization (NV) based on OCT angiography (OCTA) and to identify longitudinal morphologic changes associated with progression to exudation. DESIGN: Cohort study of contralateral eye in patients with neovascular age-related macular degeneration (nAMD) in 1 eye. PARTICIPANTS: Patients with nAMD in one eye were eligble for inclusion and enrolled between June 2015 and Jan 2017. The study eye was the contralateral eye that was free of nAMD with a minimum follow-up of 1 year. METHODS: Progressive multimodal imaging was performed on both eyes. Nonexudative NV was detected on OCTA in the study eye and quantitative changes analyzed. Nonexudative NV eyes were divided into progression to exudation or not during a minimum of 12 months follow-up. MAIN OUTCOME MEASURES: Association between systemic and ocular characteristics with nonexudative NV were determined. Change in OCTA size, vessel density, and vessel length density were compared between visits as predictors of progression to exudation. RESULTS: Among 229 study eyes, 21 (9.1%) had nonexudative NV detected on OCTA at baseline. Hyperlipidemia (adjusted odds ratio [AOR], 1.3; 95% confidence interval [CI], 1.10-3.20; P = 0.04), triglycerides (AOR, 2.84 per mmol/L; 95% CI, 1.06-4.35 per mmol/L; P = 0.02), and baseline lesion size in the presenting eye (AOR, 1.6 per 500 μm; 95% CI, 1.21-3.25 per 500 μm; P = 0.03) were associated significantly with nonexudative NV in the study eye. In the study eye nonexudative NV group, 8 (38%) progressed to exudation, with a mean time to exudation of 377 ± 138 days. The progressor group had larger baseline NV size (1834 ± 552.8 μm vs. 910 ± 461.7 μm; P < 0.01), higher increase in vessel density/year (8.3 ± 4.1%/year vs. 1.1 ± 2.5%/year; P ≤ 0.01), and higher increase in vessel length density/year (15.6 ± 10.6% vs. 1.9 ± 3.6%; P = 0.02). The change in lesion size per year was similar in both groups. CONCLUSIONS: Patients with nonexudative NV in the study eye had significant differences in ocular and systemic characteristics. More than a third of study eyes with nonexudative NV at baseline progressed to exudation, suggesting that close monitoring is essential. OCT angiography features associated with exudation include a larger baseline lesion size, increase in vessel density, and vessel length density.
PURPOSE: To describe the systemic and ocular features of fellow eyes' association with nonexudative neovascularization (NV) based on OCT angiography (OCTA) and to identify longitudinal morphologic changes associated with progression to exudation. DESIGN: Cohort study of contralateral eye in patients with neovascular age-related macular degeneration (nAMD) in 1 eye. PARTICIPANTS: Patients with nAMD in one eye were eligble for inclusion and enrolled between June 2015 and Jan 2017. The study eye was the contralateral eye that was free of nAMD with a minimum follow-up of 1 year. METHODS: Progressive multimodal imaging was performed on both eyes. Nonexudative NV was detected on OCTA in the study eye and quantitative changes analyzed. Nonexudative NV eyes were divided into progression to exudation or not during a minimum of 12 months follow-up. MAIN OUTCOME MEASURES: Association between systemic and ocular characteristics with nonexudative NV were determined. Change in OCTA size, vessel density, and vessel length density were compared between visits as predictors of progression to exudation. RESULTS: Among 229 study eyes, 21 (9.1%) had nonexudative NV detected on OCTA at baseline. Hyperlipidemia (adjusted odds ratio [AOR], 1.3; 95% confidence interval [CI], 1.10-3.20; P = 0.04), triglycerides (AOR, 2.84 per mmol/L; 95% CI, 1.06-4.35 per mmol/L; P = 0.02), and baseline lesion size in the presenting eye (AOR, 1.6 per 500 μm; 95% CI, 1.21-3.25 per 500 μm; P = 0.03) were associated significantly with nonexudative NV in the study eye. In the study eye nonexudative NV group, 8 (38%) progressed to exudation, with a mean time to exudation of 377 ± 138 days. The progressor group had larger baseline NV size (1834 ± 552.8 μm vs. 910 ± 461.7 μm; P < 0.01), higher increase in vessel density/year (8.3 ± 4.1%/year vs. 1.1 ± 2.5%/year; P ≤ 0.01), and higher increase in vessel length density/year (15.6 ± 10.6% vs. 1.9 ± 3.6%; P = 0.02). The change in lesion size per year was similar in both groups. CONCLUSIONS:Patients with nonexudative NV in the study eye had significant differences in ocular and systemic characteristics. More than a third of study eyes with nonexudative NV at baseline progressed to exudation, suggesting that close monitoring is essential. OCT angiography features associated with exudation include a larger baseline lesion size, increase in vessel density, and vessel length density.
Authors: Mengxi Shen; Qinqin Zhang; Jin Yang; Hao Zhou; Zhongdi Chu; Xiao Zhou; William Feuer; Xiaoshuang Jiang; Yingying Shi; Luis de Sisternes; Mary K Durbin; Ruikang K Wang; Giovanni Gregori; Philip J Rosenfeld Journal: Invest Ophthalmol Vis Sci Date: 2021-05-03 Impact factor: 4.799
Authors: Chui Ming Gemmy Cheung; Kelvin Yi Chong Teo; Sai Bo Bo Tun; Joanna Marie Busoy; Amutha Barathi Veluchamy; Richard F Spaide Journal: Sci Rep Date: 2020-10-05 Impact factor: 4.379