• Acta ophthalmologica · Jun 2017

    Identification and clinical role of choroidal neovascularization characteristics based on optical coherence tomography angiography.

    • Florian Sulzbacher, Andreas Pollreisz, Alexandra Kaider, Stefan Kickinger, Stefan Sacu, Ursula Schmidt-Erfurth, and Vienna Eye Study Center.
    • Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
    • Acta Ophthalmol. 2017 Jun 1; 95 (4): 414-420.

    PurposeTo suggest a novel classification of neovascular age-related macular degeneration (AMD) based on optical coherence tomography angiography (OCTA) and to correlate morphological characteristics based on optical coherence tomography (OCT)/OCTA with clinical criteria of disease activity.MethodsA total of 88 eyes with neovascular AMD (14 treatment-naïve, 74 eyes following anti-vascular endothelial growth factor treatment (VEGF)) were examined using the AngioVue OCTA system (Optovue, Inc., Fremont, CA, USA) and evaluated based on vascular morphology. Choroidal neovascularization (CNV)-vessel morphology based on OCTA and associations with retinal layers were described and correlated with clinical markers of disease activity.ResultsIn treatment-naïve CNV, CNV-vessel morphology based on OCTA showed a dense-net configuration (DN) in 12 of 14 eyes, a loose-net configuration (LN) in one of 14 eyes and an unidentifiable CNV pattern in one of 14 eyes, whereas in treated CNV, DN was registered in 43.2% (32/74), LN in 27% (20/74), DN with additional LN (mixed type) in 14.9% (11/74) and an unidentifiable CNV pattern in 14.9% (11/74). Clinical correlations revealed a significantly longer disease duration for LN with a median value of 4.3 years compared to DN with 2.0 years (p = 0.009) and for CNV involving the outer retina with 3.1 years compared to CNV not involving the outer retina with 1.9 years (p = 0.051).ConclusionOptical coherence tomography angiography (OCTA) allows identification of distinct CNV-specific vascular patterns at the level of the outer retinal layer and choriocapillaris. Correlation with clinical and functional parameters may be useful to better understand pathophysiological mechanisms and guide efficient therapeutic strategies.© 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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