Optical Coherence Tomography Angiography of Fibrosis in Age-Related Macular Degeneration

To describe the optical coherence tomography angiography (OCTA) features of subretinal fibrosis in the context of exudative age-related macular degeneration.

Patients diagnosed exudative age-related macular degeneration presenting with subretinal fibrosis were imaged by conventional multimodal imaging and OCTA. The patients were divided into the following two groups: group A, for eyes with active exudative features over the last 6 months, and group B, for eyes without any sign of exudation for >6 months.

In almost all of the patients, a high-flow network was detected inside of the fibrotic scar. We divided the vascular networks into the following three patterns: the pruned vascular tree, tangled network and vascular loop patterns. Furthermore, two types of low-flow structures, for which we coined the terms large flow void and dark halo, were observed. Both active and inactive lesions demonstrated the abovementioned patterns either individually or together. No difference was found between the two groups in the prevalent vascular network pattern of low-flow areas.

OCTA of subretinal fibrosis revealed a perfused, abnormal vascular network, as well as collateral architectural changes in the outer retina and the choriocapillaris layer, in the majority of the studied eyes. These features are associated with both active and inactive fibrotic choroidal neovessels.