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In Vivo Multimodal Imaging and Analysis of Mouse Laser-Induced Choroidal Neovascularization Model
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Quantitative Evaluation of Type 1 and Type 2 Choroidal Neovascularization Components Under Treatment With
Kotaro Tsuboi1,2, Qi Sheng You1, Jie Wang1,3
1Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, United States.
Investigative Ophthalmology & Visual Science
|September 20, 2024
Summary
Type 1 and type 2 macular neovascularization (MNV) in age-related macular degeneration (AMD) respond differently to anti-vascular endothelial growth factor (VEGF) treatment. Type 2 MNV showed significant reduction in area and volume, while type 1 MNV remained unchanged.
Area of Science:
- Ophthalmology
- Medical Imaging
- Vascular Biology
Background:
- Age-related macular degeneration (AMD) is a leading cause of vision loss.
- Exudative AMD involves the growth of abnormal blood vessels (macular neovascularization, MNV).
- Anti-vascular endothelial growth factor (anti-VEGF) therapy is a standard treatment for exudative AMD.
Purpose of the Study:
- To evaluate the differential response of type 1 and type 2 macular neovascularization (MNV) components to anti-vascular endothelial growth factor (VEGF) treatment in age-related macular degeneration (AMD).
- To utilize projection-resolved optical coherence tomography angiography (PR-OCTA) for quantitative analysis of MNV changes.
Main Methods:
- Retrospective analysis of treatment-naïve exudative AMD patients receiving anti-VEGF injections under a pro re nata (PRN) protocol for 1 year.
- Quantitative assessment of 2D MNV areas and 3D MNV volumes using PR-OCTA and a convolutional neural network.
- Separate analysis of type 1 and type 2 MNV components detected in the outer retinal slab.
Main Results:
- In pure type 1 MNV eyes (12/17), total MNV area and volume showed no significant change over 12 months.
- In type 2 MNV eyes (5/17), total MNV area significantly decreased at 6 and 12 months (P=0.0074, P=0.014).
- Type 2 MNV eyes showed a trend towards decreased volume (P=0.061-0.074), with type 2 components resolving by 12 months (P=0.0087) and type 1 components increasing (P=0.058).
Conclusions:
- Type 1 and type 2 MNV exhibit distinct responses to PRN anti-VEGF therapy over one year.
- PRN anti-VEGF treatment may lead to regression of type 2 MNV while potentially promoting type 1 MNV growth.
- Further investigation into the differential behavior of MNV subtypes under anti-VEGF treatment is warranted.
