Original StudyIMPLICATIONS OF THE MORPHOLOGIC PATTERNS OF TYPE 1 MACULAR NEOVASCULARIZATION ON MACULAR ATROPHY GROWTH ON PATIENTS UNDER ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR TREATMENTCabral, Diogo MD*,†,‡; Coscas, Florence MD‡,§; Pereira, Telmo PhD†; Laiginhas, Rita MD¶; Rodrigues, Catarina MD*; Français, Catherine MD‡; Nogueira, Vanda MD*; Falcão, Manuel MD, PhD¶; Miere, Alexandra MD, MSc§; Lupidi, Marco MD**; Coscas, Gabriel MD‡,§; Souied, Eric MD, PhD§Author Information *Instituto de Oftalmologia Dr. Gama Pinto, Lisboa, Portugal; †CEDOC, NOVA Medical School I Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisbon, Portugal; ‡Centre Ophtalmologique de l'Odéon, 113 bd Saint Germain, Paris, France; §Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil, University Paris Est Creteil XII, Creteil, France; ¶PDICSS, Faculty of Medicine of Porto University, Centro Hospitalar de Entre o Douro e Vouga; and **Department of Surgical and Biomedical Sciences, Section of Ophthalmology, University of Perugia, S. Maria della misericordia hospital, Perugia, Italy. Reprint requests: Florence Coscas, MD, Department of Ophthalmology, Centre Hospitalier Intercommunal de Creteil, 40 Avenue de Verdun, 94000 Créteil, France; e-mail: [email protected] None of the authors has any financial/conflicting interests to disclose. Retina: February 2021 - Volume 41 - Issue 2 - p 287-295 doi: 10.1097/IAE.0000000000002842 Buy Metrics AbstractIn Brief Purpose: To evaluate the correspondence between macular atrophy (MA) progression and Type 1 macular neovascularization morphology during long-term anti–vascular endothelial growth factor treatment for exudative neovascular age-related macular degeneration. Methods: Retrospective review of consecutive patients with complete retinal pigment epithelium and outer retina atrophy overlying or in the proximity of macular neovascularization. The assessment of MA was based on spectral domain optical coherence tomography, en-face near infra-red imaging and fundus autofluorescence. Macular neovascularization blood flow morphology was evaluated by swept-source optical coherence tomography-angiography. Qualitative features were categorized per ETDRS sector as: immature, mature; and hypermature pattern. An automatic analysis was designed in MATLAB coding language to compute MA per ETDRS. Measurements were compared between the baseline and the last follow-up visit. Results: Twenty eyes from 20 patients were included; the mean age was 85.4 (8.3) years. The median follow-up was 1.85 (1.0–2.4) years and the median anti–vascular endothelial growth factor injection rate during follow-up was 4.0 (2.0–5.0) injections/year. During follow-up, sectors with persistence of an immature blood flow pattern had a lower MA growth rate than sectors with mature macular neovascularization flow patterns (P = 0.001). Conclusion: The presence of an immature blood flow pattern on optical coherence tomography-angiography is associated with a lower progression rate of MA. A retrospective evaluation of patients with concurrent Type 1 macular neovascularization and macular atrophy during long-term anti–vascular endothelial growth factor treatment demonstrates that the persistence of an immature blood flow pattern on optical coherence tomography-angiography is associated with a lower progression rate of atrophy.