TY - JOUR
T1 - Detection of Nonexudative Choroidal Neovascularization and Progression to Exudative Choroidal Neovascularization Using OCT Angiography
AU - Bailey, Steven T.
AU - Thaware, O.
AU - Wang, Jie
AU - Hagag, Ahmed M.
AU - Zhang, X.
AU - Flaxel, Christina J.
AU - Lauer, Andreas K.
AU - Hwang, Thomas S.
AU - Lin, Phoebe
AU - Huang, D.
AU - Jia, Yali
N1 - Publisher Copyright:
© 2019 American Academy of Ophthalmology
PY - 2019/8
Y1 - 2019/8
N2 - Purpose: To detect nonexudative choroidal neovascularization (CNV) in age-related macular degeneration (AMD) with OCT angiography (OCTA) and determine the risk of exudative CNV developing compared with eyes without nonexudative CNV. Design: Prospective, longitudinal, observational study. Participants: Consecutive patients with drusen and pigmentary changes in the study eye and exudative neovascular AMD in the fellow eye. Methods: In this prospective observational study, participants underwent spectral-domain OCTA (AngioVue; Optovue, Inc, Fremont, CA), clinical examination, and structural OCT at baseline and 6-month intervals for 2 years. OCT angiography images were exported for custom processing to remove projection artifact and calculate CNV vessel area. Main Outcome Measures: Rate of developing exudation in eyes with and without nonexudative CNV as detected by OCTA on regular follow-up. Results: Sixty-three study participants were followed up every 6 months and 48 completed the 2-year study. Mean age was 78 years and 60.3% were female. On the baseline visit, 5 eyes (7.9%) were found to have nonexudative CNV by OCTA, and 3 of them demonstrated exudation. Of 58 eyes with a normal OCTA on baseline visit, 5 eyes developed nonexudative CNV during a follow-up visit. All 5 of these nonexudative CNV went on to develop exudation in subsequent visits. Overall, 8 of the 10 eyes with nonexudative CNV developed exudation with a mean time of 8 months and mean CNV area growth rate of 20% per month (P = 0.014, exponential model). Initiation of antiangiogenic treatment halted their growth. In comparison, exudation occurred in only 6 of the 53 eyes (11%) that lacked a precursor nonexudative CNV. Cox proportional hazard analysis showed that having nonexudative CNV detected was associated with an 18.1-fold increase in the rate of exudation subsequently developing (P < 0.0001). Conclusions: Nonexudative CNV frequently is detected by OCTA in the fellow eyes of those with exudative CNV. These lesions carry a high risk of exudation developing within the first year after detection and could benefit from close monitoring. The high risk of progression may justify prophylactic treatment; further studies are needed.
AB - Purpose: To detect nonexudative choroidal neovascularization (CNV) in age-related macular degeneration (AMD) with OCT angiography (OCTA) and determine the risk of exudative CNV developing compared with eyes without nonexudative CNV. Design: Prospective, longitudinal, observational study. Participants: Consecutive patients with drusen and pigmentary changes in the study eye and exudative neovascular AMD in the fellow eye. Methods: In this prospective observational study, participants underwent spectral-domain OCTA (AngioVue; Optovue, Inc, Fremont, CA), clinical examination, and structural OCT at baseline and 6-month intervals for 2 years. OCT angiography images were exported for custom processing to remove projection artifact and calculate CNV vessel area. Main Outcome Measures: Rate of developing exudation in eyes with and without nonexudative CNV as detected by OCTA on regular follow-up. Results: Sixty-three study participants were followed up every 6 months and 48 completed the 2-year study. Mean age was 78 years and 60.3% were female. On the baseline visit, 5 eyes (7.9%) were found to have nonexudative CNV by OCTA, and 3 of them demonstrated exudation. Of 58 eyes with a normal OCTA on baseline visit, 5 eyes developed nonexudative CNV during a follow-up visit. All 5 of these nonexudative CNV went on to develop exudation in subsequent visits. Overall, 8 of the 10 eyes with nonexudative CNV developed exudation with a mean time of 8 months and mean CNV area growth rate of 20% per month (P = 0.014, exponential model). Initiation of antiangiogenic treatment halted their growth. In comparison, exudation occurred in only 6 of the 53 eyes (11%) that lacked a precursor nonexudative CNV. Cox proportional hazard analysis showed that having nonexudative CNV detected was associated with an 18.1-fold increase in the rate of exudation subsequently developing (P < 0.0001). Conclusions: Nonexudative CNV frequently is detected by OCTA in the fellow eyes of those with exudative CNV. These lesions carry a high risk of exudation developing within the first year after detection and could benefit from close monitoring. The high risk of progression may justify prophylactic treatment; further studies are needed.
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U2 - 10.1016/j.oret.2019.03.008
DO - 10.1016/j.oret.2019.03.008
M3 - Article
AN - SCOPUS:85069889788
SN - 2468-7219
VL - 3
SP - 629
EP - 636
JO - Ophthalmology Retina
JF - Ophthalmology Retina
IS - 8
ER -