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Optical coherence tomography angiography for detection of macular neovascularization associated with atrophy in age-related macular degeneration

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To evaluate the ability of optical coherence tomography angiography (OCTA) to detect macular neovascularization (MNV) in eyes with atrophy compared with fluorescein angiography (FA), indocyanine green angiography (ICGA), and optical coherence tomography (OCT).

Methods

In this prospective study, eyes with MNV and atrophy (termed macular atrophy or MA) secondary to age-related macular degeneration (AMD), and AMD eyes with geographic atrophy (GA) without MNV underwent multimodal imaging with FA, ICGA, structural OCT, and OCTA. The presence of MNV was determined using all imaging modalities by senior retina specialists and was considered the gold standard reference. Each individual imaging modality was then evaluated independently by two expert readers for the presence of MNV in a masked fashion. Morphologic characteristics of the MNV were evaluated on the custom OCTA slab.

Results

Twenty-one patients with MA+MNV and 21 with GA only were enrolled. Manual segmentation on OCTA allowed detection of the MNV in 95.2% of eyes with MA+MNV and in 4.7% of eyes with GA, showing high specificity (95.2%) and sensitivity (95.2%). FA, ICGA, and OCT detected MNV in 57.1%, 52.3%, and 66.7% of eyes with MA+MNV and in 14.2%, 9.5%, and 42.8% with GA. Sensitivity and specificity were 85.7% and 57.1% for FA, 90.5% and 52.4% for ICGA, and 66.7% and 57.1% for OCT.

Conclusions

OCTA appears to be superior to other imaging modalities for identification of MNV in eyes with macular atrophy. OCTA should be considered as part of the multimodal imaging evaluation of eyes with atrophy, particularly in the context of clinical trials.

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Data availability

All data relevant to the study are included in the article or uploaded as supplementary information.

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Authors and Affiliations

  1. Eye Clinic, Department of Biomedical and Clinical Science “Luigi Sacco”, Sacco Hospital, University of Milan, via G.B Grassi 74, 20157, Milan, Italy

    Federico Corvi, Mariano Cozzi, Alessandro Invernizzi, Lucia Pace & Giovanni Staurenghi

  2. Doheny Eye Institute, California, Los Angeles, USA

    Federico Corvi & Srinivas R. Sadda

  3. Department of Ophthalmology, Davide Geffen School of Medicine, University of California, California, Los Angeles, USA

    Federico Corvi & Srinivas R. Sadda

  4. Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia

    Alessandro Invernizzi

Authors
  1. Federico Corvi
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  2. Mariano Cozzi
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  3. Alessandro Invernizzi
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  4. Lucia Pace
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  5. Srinivas R. Sadda
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  6. Giovanni Staurenghi
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Contributions

FC: conception and design, acquisition of data, analysis and interpretation of data, drafting the article, and final approval of the manuscript. MC: conception and design, acquisition of data drafting the article, and final approval of the manuscript. AI and LP acquisition of data, revising the article critically for important intellectual content, and final approval of the manuscript. SRS: analysis and interpretation of data, revising the manuscript critically for important intellectual content, and final approval. GS analysis and interpretation of data, acquisition of data, revising the article critically for important intellectual content, and final approval.

Corresponding author

Correspondence to Federico Corvi.

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Conflict of interest

Disclosure of potential conflicts of interest: F.Corvi, M.Cozzi and L.Pace declare no conflict of interest. A. Invernizzi: Allergan (financial support), Novartis (consultant), and Bayer (consultant). S.R. Sadda: Allergan (consultant, financial support), Carl Zeiss Meditec (financial support), Genentech (consultant, financial support), Amgen (consultant), Novartis (consultant), Optos (consultant, financial support), Centervue (consultant), Heidelberg (consultant), Regeneron (financial support), and Oxurion (consultant). G. Staurenghi: Heidelberg Engineering (consultant), Quantel Medical (consultant), Centervue (consultant), Carl Zeiss Meditec (consultant), Alcon (consultant), Allergan (consultant), Bayer (consultant), Boheringer (consultant), Genentech (consultant), GSK (consultant), Novartis (consultant), and Roche (consultant), and has received grant support from Optos (financial support), Optovue (financial support), and Centervue (financial support).

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Corvi, F., Cozzi, M., Invernizzi, A. et al. Optical coherence tomography angiography for detection of macular neovascularization associated with atrophy in age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 259, 291–299 (2021). https://doi.org/10.1007/s00417-020-04821-6

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  • DOI: https://doi.org/10.1007/s00417-020-04821-6

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