Quantitative Analysis of the Activity in Choroidal Neovascularizations after a Single Anti-VEGF Injection: OCT Versus OCT Angiography.

PURPOSE

To analyze early quantitative changes in the choroidal neovascularization (CNV) area observed with optical coherence tomography angiography (OCTA) after single anti-vascular endothelial growth factor (anti-VEGF) injection.

MATERIALS AND METHODS

Treatment-naive patients with CNV secondary to neovascular age-related macular degeneration were analyzed immediately before and ~4 weeks after anti-VEGF injection. The primary endpoints of the study included changes in CNV total and vascular area. Secondary endpoints were best-corrected visual acuity (BCVA), central macular thickness (cMT), central total macular thickness (cTMT), and subfoveal choroidal thickness (SFCT).

RESULTS

A total of 27 patients (69.19 ± 5.91 years, 21 men/6 women, 14 type 1 NV, 11 type 2 NV, and 2 type 3 NV) were included in the study. There was a significant increase in BCVA and decreases in cMT, cTMT, and SFCT after treatment (<0.05 for all). CNV total and vascular area changed by -11.55 ± 44.26% (95% confidence interval [CI]: -29.06 and 5.95; =0.269) and -21.06 ± 41.2% (95% CI: -36.45/-5.67; =0.786), respectively. The cases with decreased cTMT were accompanied by a decrease in CNV area only in 37% of the cases. No significant correlation was detected between cTMT and CNV total and vascular area percentage changes ( = -0.06, =0.74; = 0.02, =0.9, respectively).

CONCLUSIONS

Changes in CNV total and vascular area seem to have limited sensitivity as a biomarker in terms of activation, as wide variability was observed in CNV area after anti-VEGF injection.