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Changes in the OCT angiographic appearance of type 1 and type 2 CNV in exudative AMD during anti-VEGF treatment
  1. Henrik Faatz1,
  2. Marie-Louise Farecki1,
  3. Kai Rothaus1,
  4. Matthias Gutfleisch1,
  5. Daniel Pauleikhoff1,2,
  6. Albrecht Lommatzsch1,2,3
  1. 1Department of Ophthalmology, St. Franziskus Hospital Münster, Münster, Germany
  2. 2Department of Ophthalmology, University of Duisburg-Essen, Essen, Germany
  3. 3Achim Wessing Institute of Ophthalmic Diagnostic (AWIO), Essen, Germany
  1. Correspondence to Dr. Henrik Faatz; henrik.faatz{at}


Objective Optical coherence tomography angiography (OCT-A) enables detailed visualisation of the vascular structure of choroidal neovascularisation (CNV). The aim of this study was to determine whether mathematically ascertained OCT-A vascular parameters of type 1 and type 2 CNV in exudative age-related macular degeneration (AMD) change during antivascular endothelial growth factor (anti-VEGF) treatment. The OCT-A vascular parameters were also compared with previously obtained activity parameters (fluid distribution on spectral domain OCT (SD-OCT)) to establish whether they could potentially be used as further ‘activity parameters’ for assessment of anti-VEGF treatment.

Methods and Analysis We evaluated 27 eyes of 27 patients (mean follow-up 9.8 months) with type 1, type 2 or mixed CNV who had received anti-VEGF treatment (IVAN scheme). The parameters analysed were area (aCNV), total length of all vessels (tlCNV), overall number of vascular segments (nsCNV) and fractal dimension (FD) of the CNV. The changes in each of these parameters were correlated with the central foveal thickness (CFT).

Results Regression and renewed perfusion of the CNV corresponded with the decrease or increase, respectively, of macular fluid distribution on SD-OCT. The increase and decrease of CFT during anti-VEGF treatment were highly significantly correlated with changes in FD (p<0.00001), aCNV (p<0.00001), tlCNV (p<0.00001) and nsCNV (p<0.00001).

Conclusion OCT-A enables detailed analysis of AMD with regard to FD, aCNV, tlCNV and nsCNV. As the changes in these parameters correlate closely with changes on SD-OCT, they can be used as new activity parameters, alongside fluid distribution, for assessment of treatment effect and as parameters of stabilisation or the need for repeated treatment.

  • OCT-angiography
  • AMD
  • anti-VEGF treatment
  • CNV
  • imaging

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  • Contributors Conceptualisation: HF, AL and DP. Investigation: HF, M-LF and MG. Methodology: HF, KR and AL. Analysis: HF, KR, M-LF and MG. Validation: HF, KR and DP. Writing the original draft: HF, DP and AL.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was conducted according to the tenets of the Declaration of Helsinki and with patients’ consent.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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