Original StudyQUANTITATIVE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY PARAMETER VARIATIONS AFTER TREATMENT OF MACULAR NEOVASCULARIZATION SECONDARY TO AGE-RELATED MACULAR DEGENERATIONArrigo, Alessandro MD; Aragona, Emanuela MD; Bordato, Alessandro MD; Amato, Alessia MD; Borghesan, Federico MD; Bandello, Francesco MD; Parodi, Maurizio B. MDAuthor Information Department of Ophthalmology, Scientific Institute San Raffaele, Vita-Salute University, Milan, Italy. Reprint requests: Alessandro Arrigo, MD, Department of Ophthalmology, IRCCS Ospedale San Raffaele, Vita-Salute University, Via Olgettina 60, Milan, 20132, Italy; e-mail: [email protected] F. Bandello consultant for: Alcon (Fort Worth, Texas, USA), Alimera Sciences (Alpharetta, Georgia, USA), Allergan Inc (Irvine, California, USA), Farmila-Thea (Clermont-Ferrand, France), Bayer Schering Pharma (Berlin, Germany), Bausch & Lomb (Rochester, New York, USA), Genentech (San Francisco, California, USA), Hoffmann-La Roche (Basel, Switzerland), Novagali Pharma (Évry, France), Novartis (Basel, Switzerland), Sanofi-Aventis (Paris, France), ThromboGenics (Heverlee, Belgium), and Zeiss (Dublin, USA). None of the other authors has any financial/conflicting interests to disclose. Retina: July 2021 - Volume 41 - Issue 7 - p 1463-1469 doi: 10.1097/IAE.0000000000003065 Buy Metrics AbstractIn Brief Purpose: Macular neovascularization (MNV) secondary to age-related macular degeneration can be characterized by quantitative optical coherence tomography angiography. The aim of the study was to assess the evolution of quantitative optical coherence tomography angiography parameters after 1 year of antivascular endothelial growth factor injections. Methods: Naive age-related macular degeneration–related MNV eyes were prospectively recruited to analyze optical coherence tomography and optical coherence tomography angiography parameters, including MNV vessel tortuosity (VT) and reflectivity, at baseline and at the end of the follow-up. Macular neovascularization eyes were categorized by a MNV VT cutoff, and quantitative parameter variations were documented after 1 year of treatment. We divided MNV eyes into Group 1 (MNV VT < 8.40) and Group 2 (MNV VT > 8.40). Results: Thrity naive age-related macular degeneration–related MNV eyes (30 patients) were included. Our cohort included 18 Type 1 MNV and 12 Type 2 MNV lesions. Baseline central macular thickness (411 ± 85 µm) improved to 323 ± 54 µm at 1 year (P < 0.01). Only Group 1 MNV displayed significant visual improvement. Macular neovascularization VT values remained stable over the follow-up in both subgroups. Group 2 MNV eyes showed increased MNV reflectivity and increased MNV area at the end of the follow-up. Quantitative retinal capillary plexa parameters were found to be worse in Group 2 MNV. Outer retinal atrophy occurred in 2 of the 18 eyes in MNV Group 1 (11%) and in 6 of the 12 eyes in MNV Group 2 (50%) after 1 year. Vessel density proved to be always worse in Group 2 than in Group 1. Conclusion: Macular neovascularization VT provides information on the blood flow and identifies two subgroups with different final anatomical and visual outcomes, regardless of the treatment effect. Vessel tortuosity of macular neovascularization secondary to age-related macular degeneration proved stable after antivascular endothelial growth factors treatment over a 1-year follow-up. A vessel tortuosity cutoff value of 8.40 helped differentiate two anatomically and clinically different subgroups of macular neovascularization.