Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Macular neovascularization in AMD, CSC and best vitelliform macular dystrophy: quantitative OCTA detects distinct clinical entities

Abstract

Background

To perform a quantitative optical coherence tomography (OCT) angiography (OCTA) analysis of macular neovascularization (MNV) secondary to age-related macular degeneration (AMD), central serous chorioretinopathy (CSC) and best vitelliform macular dystrophy (BVMD), with the aim of highlighting quantitative features indicating different clinical entities.

Methods

Study design: prospective, interventional. We recruited patients affected by AMD, CSC or BVMD, complicated by naive MNV. All patients underwent complete ophthalmologic examination and multimodal imaging. They were treated with anti-VEGF injections, following a pro-re-nata regimen. The ensuing follow-up lasted 1 year. Quantitative dye-based angiography, OCT, and OCTA parameters were analysed to obtain cutoff values able to distinguish two clinically different patient subgroups for each retinal disease. The main outcome measures were best-corrected visual acuity (BCVA), central macular thickness, vessel density of superficial, deep and choriocapillaris plexa, vessel tortuosity (VT) of MNV, vessel dispersion of MNV, number of injections, MNV/leakage ratio, MNV size, speckled fluorescence, and outer retinal atrophy.

Results

Ninety-eight eyes affected by MNV (98 patients) were analysed. These included 66 eyes affected by AMD, 18 displaying CSC, and 14 eyes with BVMD. BCVA was alike in the three groups, both at baseline and after 1 year (p > 0.05). An MNV VT cutoff of 8.40 at baseline detected two patient subgroups differing significantly in terms of morpho-functional features, found both at baseline and at the end of the follow-up.

Conclusions

Quantitative OCTA suggested that the MNV’s VT might be able to provide a better characterization of two different morpho-functional manifestations in AMD, CSC and BVMD.

Your institute does not have access to this article

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

Fig. 1: Group 1 AMD-related MNV (MNV VT < 8.40).
Fig. 2: Group 2 AMD-related MNV (MNV VT > 8.40).
Fig. 3: Group 1 CSC-related MNV (MNV VT < 8.40).
Fig. 4: Group 2 CSC-related MNV (MNV VT > 8.40).
Fig. 5: Group 1 BVMD-related MNV (MNV VT < 8.40).
Fig. 6: Group 2 BVMD-related MNV (MNV VT > 8.40).

References

  1. Green WR, Wilson DJ. Choroidal neovascularization. Ophthalmology. 1986;93:1169–76.

    CAS  Article  Google Scholar 

  2. Spaide RF, Jaffe GJ, Sarraf D, Freund KB, Sadda SR, Staurenghi G, et al. Consensus nomenclature for reporting neovascular age-related macular degeneration data: consensus on neovascular age-related macular degeneration nomenclature study group. Ophthalmology. 2020;127:616–36.

    Article  Google Scholar 

  3. Patel R, Wang J, Campbell JP, Kiang L, Lauer A, Flaxel C, et al. Classification of choroidal neovascularization using projection-resolved optical coherence tomographic angiography. Invest Ophthalmol Vis Sci. 2018;59:4285–91.

    CAS  Article  Google Scholar 

  4. Arrigo A, Aragona E, Capone L, Pierro L, Romano F, Bandello F, et al. Advanced optical coherence tomography angiography analysis of age-related macular degeneration complicated by onset of unilateral choroidal neovascularization. Am J Ophthalmol. 2018;195:233–42.

    Article  Google Scholar 

  5. Arrigo A, Romano F, Aragona E, Di Nunzio C, Battista M, Bandello F, et al. Optical coherence tomography angiography can categorize different subgroups of choroidal neovascularization secondary to age-related macular degeneration. Retina. 2020;40:2263–69.

    CAS  Article  Google Scholar 

  6. Arrigo A, Aragona E, Di Nunzio C, Bandello F, Parodi MB. Quantitative optical coherence tomography angiography parameters in type 1 macular neovascularization secondary to age-related macular degeneration. Transl Vis Sci Technol. 2020;9:48.

    Article  Google Scholar 

  7. Jager RD, Mieler WF, Miller JW. Age-related macular degeneration. N Engl J Med. 2008;358:2606–17.

    CAS  Article  Google Scholar 

  8. Lee GI, Kim AY, Kang SW, Cho SC, Park KH, Kim SJ, et al. Risk factors and outcomes of choroidal neovascularization secondary to central serous chorioretinopathy. Sci Rep. 2019;9:3927.

    Article  Google Scholar 

  9. Khan KN, Mahroo OA, Islam F, Webster AR, Moore AT, Michaelides M. Functional and anatomical outcomes of choroidal neovascularization complicating BEST1-related retinopathy. Retina. 2017;37:1360–70.

    Article  Google Scholar 

  10. Solomon SD, Lindsley K, Vedula SS, Krzystolik MG, Hawkins BS. Anti-vascular endothelial growth factor for neovascular age-related macular degeneration. Cochrane Database Syst Rev. 2019;3:CD005139.

    PubMed  Google Scholar 

  11. Chhablani J, Pichi F, Silva R, Casella AM, Murthy H, Banker A, et al. Antiangiogenics in choroidal neovascularization associated with laser in central serous chorioretinopathy. Retina. 2016;36:901–8.

    CAS  Article  Google Scholar 

  12. Lu HQ, Wang EQ, Zhang T, Chen YX. Photodynamic therapy and anti-vascular endothelial growth factor for acute central serous chorioretinopathy: a systematic review and meta-analysis. Eye (Lond). 2016;30:15–22.

    CAS  Article  Google Scholar 

  13. Daruich A, Matet A, Dirani A, Bousquet E, Zhao M, Farman N, et al. Central serous chorioretinopathy: recent findings and new physiopathology hypothesis. Prog Retin Eye Res. 2015;48:82–118.

    CAS  Article  Google Scholar 

  14. Fan W, Abdelfattah NS, Uji A, Lei J, Ip M, Sadda SR, et al. Subfoveal choroidal thickness predicts macular atrophy in age-related macular degeneration: results from the TREX-AMD trial. Graefes Arch Clin Exp Ophthalmol. 2018;256:511–8.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alessandro Arrigo.

Ethics declarations

Conflict of interest

FB is a consultant for Alcon (Fort Worth, Texas, USA), Alimera Sciences (Alpharetta, Georgia, USA), Allergan Inc. (Irvine, California, USA), Farmila-Thea (Clermont-Ferrand, France), Bayer Shering-Pharma (Berlin, Germany), Bausch And Lomb (Rochester, New York, USA), Genentech (San Francisco, California, USA), Hoffmann-La-Roche (Basel, Switzerland), Novagali Pharma (Évry, France), Novartis (Basel, Switzerland), Sanofi-Aventis (Paris, France), Thrombogenics (Heverlee, Belgium), Zeiss (Dublin, USA). All other authors declare that they have no conflict of interest.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Arrigo, A., Bordato, A., Aragona, E. et al. Macular neovascularization in AMD, CSC and best vitelliform macular dystrophy: quantitative OCTA detects distinct clinical entities. Eye 35, 3266–3276 (2021). https://doi.org/10.1038/s41433-021-01396-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41433-021-01396-2

Search

Quick links