Relationship between Neovascular Density in Swept Source-Optical Coherence Tomography Angiography and Signs of Activity in Exudative Age-Related Macular Degeneration

Abstract EN

Purpose.

To assess the relationship between signs of activity in exudative neovascular age-related macular degeneration (nAMD) following anti-vascular endothelial growth factor (anti-VEGF) treatment and morphology of choroidal neovascularization (CNV) based on neovascular density as imaged using swept source-optical coherence tomography angiography (SS-OCTA) in a qualitative manner.

Methods.

A single-cohort retrospective data analysis from one tertiary eye care center.

Seventy-seven eyes of 72 patients were included and their charts reviewed which had been started on intravitreal injections with anti-VEGF for nAMD at least one year prior to enrollment.

Clinically active disease was evaluated by slit-lamp fundus examination and spectral domain-OCT B-scans.

Morphological appearance in SS-OCTA was characterized based on 5 different criteria and subsequently divided into 3 groups: predominantly hyperdense, minimally hyperdense, and hypodense lesions.

Results.

Fifty-eight eyes (75%) were considered clinically active and 19 eyes (25%) clinically inactive.

CNV was depicted in 71 eyes (92%) by SS-OCTA and separated accordingly into predominantly hyperdense (32%), minimally hyperdense (34%), and hypodense lesions (34%).

A borderline significant difference in the probability of neovascular activity for predominantly hyperdense lesions compared to hypodense lesions was detected (p=0.05).

Conclusions.

Hyperdense choroidal neovascularization based on qualitative assessment of flow density showed a significant relation to active disease.

Inactivity could not be matched adequately.

This study demonstrated the potential usefulness of SS-OCTA for guidance of treatment in age-related macular degeneration.