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Updated: Mar 13, 2026

Retinal Vascular Reactivity as Assessed by Optical Coherence Tomography Angiography
Published on: March 26, 2020
TYPE 3 NEOVASCULARIZATION IMAGED WITH CROSS-SECTIONAL AND EN FACE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY
Anna C S Tan1, Kunal K Dansingani, Lawrence A Yannuzzi
1*Vitreous Retina Macula Consultants of New York, New York, New York; †LuEsther T Mertz Retinal Research Center, Manhattan, Eye, Ear and Throat Hospital, New York, New York; ‡Singapore National Eye Center/Singapore Eye Research Institute, Singapore, Singapore; §Moorfield Eye Hospital, London, United Kingdom; ¶Truhlsen Eye Institute, University of Nebraska, Omaha, Nebraska; **Stein Eye Institute, University of California, Los Angeles, California; ††Greater Los Angeles VA Healthcare Center, Los Angeles, California; and ‡‡Department of Ophthalmology, New York University School of Medicine, New York, New York.
Purpose:
To study the cross-sectional and en face optical coherence tomography angiography (OCTA) findings in Type 3 neovascularization (NV).
Methods:
Optical coherence tomography angiography imaging of 27 eyes of 23 patients with Type 3 NV was analyzed with 9 eyes having consecutive follow-up OCTA studies.
Results:
Type 3 NV appeared as a linear high-flow structure on cross-sectional OCTA corresponding to a high-flow tuft of vessels seen on en face OCTA. Cross-sectional OCTA seemed to enable the distinction between vascular and nonvascular intraretinal hyperreflective foci. Two patterns of flow were observed; Pattern 1 (11%): a flow signal confined to the neurosensory retina and Pattern 2 (74%): a flow signal extending through the retinal pigment epithelium. No definitive retinal-choroidal anastomosis was observed; however, projection artifacts confounded the interpretation of deeper structures. An increase in the intensity of the high-flow tuft was seen during the progression or recurrence of Type 3 NV. Intravitreal anti-vascular endothelial growth factor therapy caused a reduction in the intensity of the high-flow tuft which was not sustained.
Conclusion:
Compared with conventional imaging, OCTA may improve detection and delineation of vascular changes occurring in Type 3 NV. Cross-sectional and en face OCTA may prove useful in studying the pathogenesis and guiding the management of these lesions.
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