Study of optical coherence tomography angiography for myopic choroidal neovascularization_West China Medical Journal

Authors：

MIN Xiaoxue , ZHOU Sirui , MU Jia , LIU Yilin ,  ZHANG Ming

Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

ZHANG Ming, Email: zhangmingscu@126.com

Keywords：

Optical coherence tomography angiography; Myopic choroidal neovascularization; Vascular endothelial growth factor

DOI：

10.7507/1002-0179.201806022

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To analyze the characteristics of myopic choroidal neovascularization (mCNV) and the outcome of intravitreal anti-vascular endothelial growth factor (VEGF) treatment by using optical coherence tomography angiography (OCTA). Methods A prospective study was carried out, which included 34 eyes of 31 patients with mCNV in West China Hospital of Sichuan University between May and December 2017. OCTA scans were conducted to all patients before treatment, 1 day, 1 week, 1 month and 3–6 months after treatment. The analysis was performed to evaluate the morphological characteristics, lesion area, parafoveal superficial vessel density and perfusion area of choroidal neovascularization before and after treatment. Results Among mCNV patients, small round crumby lesions, small branches, and capillaries responded well to anti-VEGF treatment. Compared with the mean lesion area in mCNV patients before treatment [(0.082±0.013) mm²], there was instant reduction 1 day after treatment [(0.064±0.013) mm²] and obviously decreased after 1 week [(0.046±0.011) mm²]. The parafoveal superficial vessel density and perfusion area before treatment were (15.2±0.5)% and (32.6±1.5)%, respectively, and obvious decrease was observed both in parafoveal superficial vessel density [(12.1±0.9)%] and perfusion area [(27.4±2.0)%] 1 day after treatment in mCNV patients, which began to recover 1 month after treatment. Conclusions OCTA is a non-invasive diagnostic examination, which can clearly identify tiny structures of mCNV, quantify the lesion area and display specific vasculature in mCNV patients. Furthermore, retinal microcirculation can be detected by using OCTA, which provides an effective approach of monitoring the progression and treatment effect of mCNV.

Citation： MIN Xiaoxue, ZHOU Sirui, MU Jia, LIU Yilin, ZHANG Ming. Study of optical coherence tomography angiography for myopic choroidal neovascularization. West China Medical Journal, 2018, 33(11): 1382-1387. doi: 10.7507/1002-0179.201806022 Copy

1.	Wong TY, Ferreira A, Hughes R, et al. Epidemiology and disease burden of pathologic myopia and myopic choroidal neovascularization: an evidence-based systematic review. Am J Ophthalmol, 2014, 157(1): 9-25.e12.
2.	Cohen SY, Laroche A, Leguen Y, et al. Etiology of choroidal neovascularization in young patients. Ophthalmology, 1996, 103(8): 1241-1244.
3.	Hampton GR, Kohen D, Bird AC. Visual prognosis of disciform degeneration in myopia. Ophthalmology, 1983, 90(8): 923-926.
4.	Ha SO, Kim DY, Sohn CH, et al. Anaphylaxis caused by intravenous fluorescein: clinical characteristics and review of literature. Intern Emerg Med, 2014, 9(3): 325-330.
5.	Kwiterovich KA, Maguire MG, Murphy RP, et al. Frequency of adverse systemic reactions after fluorescein angiography. Results of a prospective study. Ophthalmology, 1991, 98(7): 1139-1142.
6.	Castillo MM, Mowatt G, Elders A, et al. Optical coherence tomography for the monitoring of neovascular age-related macular degeneration: a systematic review. Ophthalmology, 2015, 122(2): 399-406.
7.	Huang D, Jia Y, Rispoli M, et al. Optical coherence tomography angiography of time course of choroidal neovascularization in response to anti-angiogenic treatment. Retina, 2015, 35(11): 2260-2264.
8.	Farecki ML, Gutfleisch M, Faatz H, et al. Characteristics of type 1 and 2 CNV in exudative AMD in OCT-angiography. Graefes Arch Clin Exp Ophthalmol, 2017, 255(5): 913-921.
9.	de Carlo TE, Bonini Filho MA, Chin AT, et al. Spectral-domain optical coherence tomography angiography of choroidal neovascularization. Ophthalmology, 2015, 122(6): 1228-1238.
10.	Heier JS, Brown DM, Chong V, et al. Intravitreal aflibercept (VEGF Trap-Eye) in wet age-related macular degeneration. Ophthalmology, 2012, 119(12): 2537-2548.
11.	Brown DM, Michels M, Kaiser PK, et al. Ranibizumab versus verteporfin photodynamic therapy for neovascular age-related macular degeneration: two-year results of the ANCHOR study. Ophthalmology, 2009, 116(1): 57-65.e5.
12.	Bruyère E, Miere A, Cohen SY, et al. Neovascularization secondary to high myopia imaged by optical coherence tomography angiography. Retina, 2017, 37(11): 2095-2101.
13.	Cheng Y, Li Y, Huang X, et al. Application of optical coherence tomography angiography to assess anti-vascular endothelial growth factor therapy in myopic choroidal neovascularization. Retina, 2017. doi: 10.1097/IAE.0000000000002005.
14.	Miere A, Butori P, Cohen SY, et al. Vascular remodeling of choroidal neovascularization after anti-vascular endothelial growth factor therapy visualized on optical coherence tomography angiography. Retina, 2017. doi: 10.1097/IAE.0000000000001964.
15.	Kuehlewein L, Bansal M, Lenis TL, et al. Optical coherence tomography angiography of type 1 neovascularization in age-related macular degeneration. Br J Ophthalmol, 2015, 160(4): 739-748.
16.	Mastropasqua L, Toto L, Borrelli E, et al. Optical coherence tomography angiography assessment of vascular effects occurring after aflibercept intravitreal injections in treatment-naive patients with wet age-related macular degeneration. Retina, 2017, 37(2): 247-256.
17.	Mo J, Duan A, Chan S, et al. Vascular flow density in pathological myopia: an optical coherence tomography angiography study. BMJ Open, 2017, 7(2): e013571.
18.	冯立淼, 杨叶, 胡亮, 等. 应用光学相干断层扫描血管成像技术分析近视眼黄斑区微血管变化. 温州医科大学学报, 2017, 47(6): 391-396.

1. Wong TY, Ferreira A, Hughes R, et al. Epidemiology and disease burden of pathologic myopia and myopic choroidal neovascularization: an evidence-based systematic review. Am J Ophthalmol, 2014, 157(1): 9-25.e12.
2. Cohen SY, Laroche A, Leguen Y, et al. Etiology of choroidal neovascularization in young patients. Ophthalmology, 1996, 103(8): 1241-1244.
3. Hampton GR, Kohen D, Bird AC. Visual prognosis of disciform degeneration in myopia. Ophthalmology, 1983, 90(8): 923-926.
4. Ha SO, Kim DY, Sohn CH, et al. Anaphylaxis caused by intravenous fluorescein: clinical characteristics and review of literature. Intern Emerg Med, 2014, 9(3): 325-330.
5. Kwiterovich KA, Maguire MG, Murphy RP, et al. Frequency of adverse systemic reactions after fluorescein angiography. Results of a prospective study. Ophthalmology, 1991, 98(7): 1139-1142.
6. Castillo MM, Mowatt G, Elders A, et al. Optical coherence tomography for the monitoring of neovascular age-related macular degeneration: a systematic review. Ophthalmology, 2015, 122(2): 399-406.
7. Huang D, Jia Y, Rispoli M, et al. Optical coherence tomography angiography of time course of choroidal neovascularization in response to anti-angiogenic treatment. Retina, 2015, 35(11): 2260-2264.
8. Farecki ML, Gutfleisch M, Faatz H, et al. Characteristics of type 1 and 2 CNV in exudative AMD in OCT-angiography. Graefes Arch Clin Exp Ophthalmol, 2017, 255(5): 913-921.
9. de Carlo TE, Bonini Filho MA, Chin AT, et al. Spectral-domain optical coherence tomography angiography of choroidal neovascularization. Ophthalmology, 2015, 122(6): 1228-1238.
10. Heier JS, Brown DM, Chong V, et al. Intravitreal aflibercept (VEGF Trap-Eye) in wet age-related macular degeneration. Ophthalmology, 2012, 119(12): 2537-2548.
11. Brown DM, Michels M, Kaiser PK, et al. Ranibizumab versus verteporfin photodynamic therapy for neovascular age-related macular degeneration: two-year results of the ANCHOR study. Ophthalmology, 2009, 116(1): 57-65.e5.
12. Bruyère E, Miere A, Cohen SY, et al. Neovascularization secondary to high myopia imaged by optical coherence tomography angiography. Retina, 2017, 37(11): 2095-2101.
13. Cheng Y, Li Y, Huang X, et al. Application of optical coherence tomography angiography to assess anti-vascular endothelial growth factor therapy in myopic choroidal neovascularization. Retina, 2017. doi: 10.1097/IAE.0000000000002005.
14. Miere A, Butori P, Cohen SY, et al. Vascular remodeling of choroidal neovascularization after anti-vascular endothelial growth factor therapy visualized on optical coherence tomography angiography. Retina, 2017. doi: 10.1097/IAE.0000000000001964.
15. Kuehlewein L, Bansal M, Lenis TL, et al. Optical coherence tomography angiography of type 1 neovascularization in age-related macular degeneration. Br J Ophthalmol, 2015, 160(4): 739-748.
16. Mastropasqua L, Toto L, Borrelli E, et al. Optical coherence tomography angiography assessment of vascular effects occurring after aflibercept intravitreal injections in treatment-naive patients with wet age-related macular degeneration. Retina, 2017, 37(2): 247-256.
17. Mo J, Duan A, Chan S, et al. Vascular flow density in pathological myopia: an optical coherence tomography angiography study. BMJ Open, 2017, 7(2): e013571.
18. 冯立淼, 杨叶, 胡亮, 等. 应用光学相干断层扫描血管成像技术分析近视眼黄斑区微血管变化. 温州医科大学学报, 2017, 47(6): 391-396.

West China Medical Journal

Study of optical coherence tomography angiography for myopic choroidal neovascularization

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