![]() With the advent of anti-vascular endothelial growth factor (anti-VEGF) drugs, different therapeutic protocols, either a pro-re-nata (PRN) or a treat-and-extend regimen, have been advocated to improve the visual outcomes of nAMD 5, 6.ĬNV shapes and morphological features, such as “sea fan” or “medusa,” tiny branching vessels, anastomoses loops, peripheral arcades, and perilesional hypointense halos have been indicated as active lesions 7, 8, 9. CNV shapes and morphological changes in response to treatment can be monitored by OCTA imaging. Recently, optical coherence tomography angiography (OCTA) has been introduced to provide better visualization of the morphology of the retinal and choroidal vasculature in a noninvasive manner 3, 4. Moreover, these invasive procedures can result in systemic allergic reactions due to dye injection. However, CNV lesions on fluorescein angiography (FA) or indocyanine green angiography (ICGA) are obscured by vessel leakage, which prevents the precise assessment of the microvascular morphological features. Conventional dye-based angiography has been considered the gold standard for diagnosis and classification of CNV. Choroidal neovascularization (CNV) is a distinct feature of neovascular age-related macular degeneration (nAMD) and is characterized by the abnormal growth of blood vessels sprouting from the choroid through the Bruch’s membrane 2. The combination of two potential biomarkers of CNV on OCTA shows good discrimination for the prediction of recurrent exudation auxiliary to structural OCT that might associate with disease activity.Īge-related macular degeneration (AMD) is the leading cause of blindness in people over 50 years of age, accounting for 8.7% of all blindness worldwide 1. “Anastomoses and loops” and “vessel density” predicted an active CNV status with a probability of 93.7% and achieved the best performance. A significantly higher vessel density was found in the active group (median 39.6% vs 30.5%, p = 0.003). Qualitative biomarkers of CNV showed significant differences between the two groups (branching capillaries: 48.1% vs 6.9%, p = 0.001 anastomoses and loops: 81.5% vs 13.8%, p < 0.001 peripheral arcade: 40.7% vs 10.3%, p = 0.013, and hypointense halo: 81.5% vs 41.4%, p = 0.002). Twenty-seven eyes (48.2%) were classified as the “active group”, and 29 eyes (51.8%) were categorized as the “silent group”. Fifty-six eyes of 56 patients were included in the study. The enrolled eyes were divided into two groups based on treatment intervals during follow-up, including an active group with less than 12 weeks intervals and a stable group with 12 weeks or longer intervals. Qualitative and quantitative CNV responses on OCTA after serial injections were analyzed. Patients diagnosed with type 1 or type 2 CNV via multimodal imaging who had received anti-VEGF treatment were retrospectively reviewed. To investigate choroidal neovascularization (CNV) characteristics after anti-vascular endothelial growth factor (anti-VEGF) therapy in patients with neovascular age-related macular degeneration by optical coherence tomography angiography (OCTA) and to assess the potential predictive role of combined qualitative and quantitative biomarkers for disease activity.
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