SD-OCT AND OCTA: Distinct or Additional Information on Neovascular Activity? The COCTAEYL Study

Area of Science:

• Ophthalmology
• Medical Imaging
• Retinal Diseases

Background:

• Neovascular age-related macular degeneration (nAMD) is a leading cause of vision loss.
• Intravitreal anti-VEGF therapy, such as aflibercept, is a standard treatment for nAMD.
• Monitoring for disease recurrence and exudative activity is crucial for treatment management.

Purpose of the Study:

• To compare exudative recurrence detection between optical coherence tomography angiography (OCTA) and spectral-domain optical coherence tomography (SD-OCT).
• To characterize OCTA-derived profiles predictive of recurrence in nAMD patients treated with aflibercept.
• To evaluate the diagnostic performance of OCTA versus SD-OCT for exudative activity.

Main Methods:

• Prospective observational cohort study with 49 patients and 686 examinations.
• Monthly monitoring following an initial aflibercept loading phase.
• Simultaneous SD-OCT and OCTA imaging at each visit for 12 months.

Main Results:

• OCTA showed 72% sensitivity and 27% specificity for exudative activity detection.
• The area under the ROC curve (AUC) for OCTA-defined recurrence was 0.49.
• Relying on OCTA did not reduce the number of unnecessary intravitreal injections compared to SD-OCT.

Conclusions:

• OCTA and SD-OCT provide complementary information for assessing nAMD activity.
• OCTA visualizes vascular remodeling, while SD-OCT shows exudative features.
• No modification in clinical management was observed based on OCTA findings in this cohort.