Zhang Juan , Li Hua , Luo Chenjun , Zhang Liwei , Li Juanjuan
  • Department of Ophthalmology, Yunnan Second People’s Hospital, Kunming 650021, China;
Li Juanjuan, Email: ljj800502@163.com
Wet macular degeneration; Choroidal neovascularization; Tomography, optical coherence
10.3760/cma.j.issn.1005-1015.2019.01.009
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Objective  To observe the OCT angiography imaging features of choroidal neovascularization (CNV) with different activity in age-related macular degeneration (AMD). Methods  A retrospective case analysis. Forty-two eyes of 33 patients (21 males and 12 females, aged 65.3±8.61 years) who were diagnosed with AMD by multi-mode fundus imaging examination at the Ophthalmology Department of Yunnan Second People's Hospital during January 2017 and October 2018 were enrolled in this study. All patients underwent BCVA, slit-lamp biomicroscopy, indirect ophthalmoscopy, fundus colorized photography, FAF, FFA and OCT examinations. The patients were divided into active CNV (27 eyes of 19 patients) and inactive CNV (15 eyes of 14 patients) by comprehensive analysis of fundus imaging characteristics and treatment process. The imaging features of OCTA in the two groups were compared. The number of eyes of each active or inactive indicator in the active CNV group and the inactive CNV group was calculated, and the composition ratio of each group of the indicators was subjected to the χ2 test. Results  Among the 27 eyes of active CNV, 22 eyes (81.5%) of OCTA showed abundant small capillary branching structure, while 13 eyes (13.3%) of 15 eyes of inactive CNV showed more coarse blood vessel. Among the 27 eyes of active CNV, 26 eyes (96.3%) of OCTA showed that the marginal vascular end points of CNV lesions were "arcaded" or "ring", while 12 eyes (80.0%) of 15 eyes of inactive CNV showed the presence of isolated branches of peripheral vessels. Among the 27 eyes with active CNV lesions, there were no large feeder vessels inside the lesions, and 8 (53.3%) of the 15 inactive CNV lesions showed feeder vessels in the center of the lesion. Among the 27 eyes with active lesions, 23 eyes (85.2%) of OCTA showed a low-reflection "halo" around the CNV lesion, and no low-reflection "halo" structure was observed in the 5 eyes of the inactive CNV lesion. The statistical results showed that there were abundant small blood vessel branches (χ2=22.759, P=0.000), annular anastomosis around the lesion (χ2=31.704, P=0.000), low-reflection halo (χ2=32.327, P=0.000), and large nourishing blood vessels (χ2=26.063, P=0.000), dilated choroidal vessels (χ2=32.912, P=0.000). All the above indicators were statistically different between the two groups. Conclusion  The abundant small vessel branches in OCTA, the surrounding anastomosis in a ring structure and the low reflex halo around the lesion are markers of active CNV, while the large feeding vessels and dilated choroidal vessels are indicators of inactive CNV.

Citation： Zhang Juan, Li Hua, Luo Chenjun, Zhang Liwei, Li Juanjuan. Optical coherence tomography angiography imaging features of choroidal neovascularization with different activity in age-related macular degeneration. Chinese Journal of Ocular Fundus Diseases, 2019, 35(1): 40-44. doi: 10.3760/cma.j.issn.1005-1015.2019.01.009 Copy