Sequential Morphological Changes in the CNV Net after Intravitreal Anti-VEGF Evaluated with OCT Angiography
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In Vivo Multimodal Imaging and Analysis of Mouse Laser-Induced Choroidal Neovascularization Model
Published on: January 21, 2018
João Pedro Marques1, José Filipe Costa, Marco Marques
1Department of Ophthalmology, Centro Hospitalar e Universitx00E1;rio de Coimbra (CHUC), Coimbra, Portugal.
Purpose:
To assess and describe sequential morphological changes in the choroidal neovascularization (CNV) net using optical coherence tomography angiography (OCTA) in patients undergoing treatment with intravitreal antivascular endothelial growth factor (VEGF).
Methods:
Prospective cohort study. OCTA was performed sequentially: before (t0), 1 h (t1), 1 week (t2) and 1 month after the injection (t3), using Avanti RTVue XR equipped with the AngioVue® software (Optovue, Calif., USA). All images were classified by two independent graders.
Results:
Ten eyes of 10 patients, with a mean age of 72.4 ± 10.5 years, were included. CNV morphology was described as tree-like in 5 eyes, glomerular in 1 and fragmented in 4. A fibrovascular capsule surrounding the CNV net was found in 4 eyes and a feeder trunk was noticed in 6. No changes were observed at t1. Loss of peripheral capillaries, vessel fragmentation and decreased vessel density were evident in 8 eyes at t2. The CNV capillary density and the peripheral anastomosis increased in all of these at t3. Two eyes remained unchanged through the whole length of follow-up.
Conclusions:
Significant changes in the CNV net can be observable in OCTA at least 1 week after intravitreal anti-VEGF. The safety of frequent examinations may provide a method of gauging treatment effects.
Insights
Optical coherence tomography angiography (OCTA) reveals significant changes in choroidal neovascularization (CNV) nets within one week of anti-vascular endothelial growth factor (VEGF) treatment. Frequent OCTA scans can monitor treatment effectiveness.
Area of Science:
- Ophthalmology
- Medical Imaging
- Vascular Biology
Background:
- Choroidal neovascularization (CNV) is a leading cause of vision loss.
- Intravitreal anti-vascular endothelial growth factor (VEGF) therapy is a standard treatment for CNV.
- Understanding the dynamic changes in CNV morphology post-treatment is crucial for assessing therapeutic response.
Purpose of the Study:
- To sequentially assess and describe morphological changes in the choroidal neovascularization (CNV) net.
- To utilize optical coherence tomography angiography (OCTA) for visualizing these changes.
- To evaluate the impact of intravitreal anti-VEGF treatment on CNV morphology over time.
Main Methods:
- Prospective cohort study design.
- Sequential OCTA imaging performed at baseline (t0), 1 hour (t1), 1 week (t2), and 1 month (t3) post-injection.
- Independent grading of all OCTA images by two specialists.
Main Results:
- CNV morphology varied, including tree-like, glomerular, and fragmented patterns.
- Fibrovascular capsules and feeder trunks were observed in a subset of patients.
- Significant changes like peripheral capillary loss and decreased vessel density were noted by 1 week (t2).
- CNV capillary density and peripheral anastomosis increased by 1 month (t3) in most affected eyes.
Conclusions:
- Morphological changes in CNV nets are detectable via OCTA as early as one week after intravitreal anti-VEGF therapy.
- The safety and efficacy of frequent OCTA examinations can serve as a method for gauging treatment effects.
- OCTA provides valuable insights into the dynamic response of CNV to anti-VEGF treatment.
