Abstract
Objective
To investigate the evolution of treatment-naive type 3 macular neovascularization
(MNV) undergoing anti-vascular endothelial growth factor (VEGF) treatment through
volume rendered three-dimensional (3D) optical coherence tomography angiography (OCTA).
Design
Retrospective observational study.
Participants
Patients with type 3 MNV and age-related macular degeneration (AMD).
Methods
Included subjects had three loading injections of an anti-VEGF agent. The OCTA volume
data at baseline and follow-up were processed with a previously published algorithm
in order to obtain a volume-rendered representation of type 3 MNV. Progressive changes
in type 3 lesions were analyzed via 3D OCTA volume rendering.
Results
A total of 14 treatment-naive eyes with type 3 MNV from 11 AMD patients (7 females)
were included. At both baseline and follow-up visits, a type 3 MNV complex was identifiable.
Each complex was composed of a mean number of 2.5 ± 0.7 vascular branches at baseline
and 1.4 ± 0.6 at the follow-up visit (p < 0.0001). The mean changes in central macular thickness and visual acuity were significantly
correlated with modifications in the number of type 3 MNV branches (ρ = –0.533, p = 0.049, and ρ = –0.581, and p = 0.040, respectively).
Conclusions
This study demonstrated that type 3 lesions do not disappear completely after loading
treatment, as indicated previously by histopathologic studies. Importantly, quantitative
volume changes in type 3 lesions are directly associated with treatment response.
Résumé
Objectif
Examiner l’évolution d'une néovascularisation maculaire (NVM) de type 3 chez des patients
qui n'ont jamais été traités et auxquels on administre un anti-VEGF (facteur de croissance
endothélial vasculaire) grâce aux images obtenues à l'angiographie-tomographie par
cohérence optique (OCTA) tridimensionnelle (3D) par le biais de rendu volumique.
Nature
Étude d'observation rétrospective.
Participants
Patients présentant une NVM de type 3 et une dégénérescence maculaire liée à l’âge
(DMLA).
Méthodes
Les participants ont reçu 3 bolus d'un anti-VEGF. On a eu recours à un algorithme
publié antérieurement pour manipuler les données de l'OCTA au départ et lors du suivi
afin d'obtenir une représentation de la NVM de type 3 par le biais de rendu volumique.
Les modifications progressives des lésions de type 3 ont été analysées grâce à l'OCTA
en 3D par le biais de rendu volumique.
Résultats
Au total ont été inclus 14 yeux (11 patients qui avaient une DMLA, dont 7 femmes)
qui présentaient une NVM de type 3 qui n'avait jamais été traitée. Il était possible
d'identifier un complexe « NVM de type 3 » tant à la visite de départ qu’à celle de
suivi. Chaque complexe comprenait un nombre moyen de 2,5 ± 0,7 branches vasculaires
au départ et de 1,4 ± 0,6 lors de la visite de suivi (p < 0,0001). On a pu établir
une corrélation significative entre la variation moyenne de l’épaisseur maculaire
centrale et de l'acuité visuelle, d'une part, et les modifications du nombre de branches
de NVM de type 3, d'autre part (p = –0,533; p = 0,049; p = –0,581 et p = 0,040, respectivement).
Conclusions
Notre étude a révélé que les lésions de type 3 ne disparaissent pas complètement après
l'administration de bolus, comme le révélaient des études histopathologiques antérieures.
Fait à noter, les variations quantitatives du volume des lésions de type 3 sont directement
associées à la réponse thérapeutique.
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Article Info
Publication History
Published online: May 28, 2021
Identification
Copyright
© 2021 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
