Abstract
Objectives
We sought to identify the consecutive changes and predictive features for exudation recurrence in macular neovascularization (MNV) using optical coherence tomography angiography (OCTA) in type 1 neovascular age-related macular degeneration (NVAMD).
Methods
A total of 291 OCTA images in consecutive visit of 45 patients newly diagnosed with type 1 NMV and treated with three loading intravitreal anti–vascular endothelial growth factor injections (IVIs) and a pro-re-nata (PRN) therapy regimen were analysed. Quantitative features of OCTA included the MNV area, MNV length, total number of endpoints (open-ended vessels) and junctions (internal branching) using AngioTool. Two subgroups were divided according to exudation recurrence time from the third IVI (group 1: ≤3 months vs. group 2: >3 months).
Results
The area, length, number of total junctions, and endpoints decreased during three loading IVIs and increased at exudation recurrence (all p < 0.05). In a subgroup analysis of consecutive OCTA images, the number of total endpoints increased at two months prior to exudate recurrence in group 2 (the late recurrence group, p = 0.020). A higher total number of endpoints of MNV at baseline were found to be related with group 1 (early recurrence, p = 0.020 and 0.012 in univariate and multivariate regression analyses).
Conclusions
The MNV with higher open-ended vessels at the lesion periphery at baseline might be expected to show earlier recurrence of exudation after loading IVIs. By observing the number of open-ended vessels in consecutive OCTA images, exudation recurrence could be predicted.
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Funding
This research was supported in part by the Bio & Medical Technology Development Program of the NRF funded in part by the Korean government, the Ministry of Science and ICT (MSIP) (NRF-2017M3A9E2056458, and 2020R1A2C1005729), and was also supported by a Korea University Guro Hospital Grant (O1905421). The sponsor or funding organization had no role in the design or conduct of this research.
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MC and SWK were involved in the conception and design of the study. MC and SWK were involved in data collection and literature research. SWK, CY, JHO and JO were involved in the interpretation and critical revision of the article. MC was involved in the data analysis and drafting of the manuscript. MC, SWK, CY, JHO and JO were involved in the final approval of the article.
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Choi, M., Kim, SW., Yun, C. et al. Predictive role of optical coherence tomography angiography for exudation recurrence in patients with type 1 neovascular age-related macular degeneration treated with pro-re-nata protocol. Eye 37, 34–41 (2023). https://doi.org/10.1038/s41433-021-01879-2
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DOI: https://doi.org/10.1038/s41433-021-01879-2
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