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APPLICATION OF OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY TO ASSESS ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY IN MYOPIC CHOROIDAL NEOVASCULARIZATION

Cheng, Ying, MD; Li, Ying, MD; Huang, Xin, MD; Qu, Yi, MD, PhD

doi: 10.1097/IAE.0000000000002005
Original Study: PDF Only

Purpose: Using optical coherence tomography (OCT) angiography to assess the therapeutic effect of intravitreal anti–vascular endothelial growth factor on myopic choroidal neovascularization (CNV) by detecting the changes of shape, size, and flow area.

Methods: Our prospective case series recruited consecutive patients with myopic CNV from January 2016 to August 2016. Intravitreal injections of ranibizumab were conducted on all patients. Patients received OCT angiography on 3 different follow-ups, including before treatment, 1 week after treatment, and 1 month after treatment. At each visit, we measured the best-corrected visual acuity, central macular thickness , greatest linear dimension of CNV, selected CNV area and flow area using OCT angiography.

Results: This study involved 13 eyes of 12 patients, in which 9 eyes were of 9 women and 4 eyes were of 3 men, with mean age of 49.92 ± 14.79 years. Best-corrected visual acuity was significantly improved with decreased central macular thickness, greatest linear dimension, intraretinal fluid, or subretinal fluid 7 days or 30 days after treatment (All P < 0.05). Myopic CNV was presented as irregular or nearly round closed mass at the level of the outer retinal layer in all eyes at the initial visit. Thirty days after treatment, the size of selected CNV area and flow area were further decreased (t = 4.012, P = 0.003).

Conclusion: Combined with OCT B-scan, OCT angiography, a new technique, could provide sensitive and intuitive images and quantitative analysis for monitoring and evaluating the therapeutic effect of intravitreal anti–vascular endothelial growth factor for myopic CNV.

To the best of our knowledge, this is the first report to note decreased choroidal neovascularization flow area in eyes with myopic choroidal neovascularization after anti–vascular endothelial growth factor therapy using optical coherence tomography angiography. They are obviously more sensitive and intuitive than central macular thickness and greatest linear dimension to evaluate the therapeutic effect. And, we hypothesize that primary attention should be paid to outer retinal layer when choroidal neovascularization lesion doubtfully appears, which simultaneously guides us to seize the main morphological character of choroidal neovascularization. On the optical coherence tomography angiography images, we noticed that the hyperdense frame lesion still existed after antiangiogenic therapy, which was considered as relatively large and mature vessels.

Department of Geriatrics, Qilu Hospital of Shandong University, Jinan, China.

Reprint requests: Yi Qu, MD, PhD, Department of Geriatrics, Qilu Hospital of Shandong University, No. 107, Wenhuaxi Road, Jinan 250012, China; e-mail: yiqucn@sdu.edu.cn

Supported in part by National Natural Science foundation of China (31570789). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

None of the authors has any conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.