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Assessing the long-term evolution of type 3 neovascularization in age-related macular degeneration using optical coherence tomography angiography

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To analyze the evolution of type 3 neovascularization in eyes with age-related macular degeneration during anti-vascular endothelial growth factor (VEGF) treatment using optical coherence tomography angiography (OCTA) analysis.

Methods

Forty-one treatment-naïve eyes (37 patients) with type 3 neovascularization were retrospectively included in the study. The growth and morphological changes in the type 3 lesions, which were recorded using OCTA, were compared across time.

Results

The high-flow signal of the lesion on OCTA was significantly increased at the sub-retinal pigment epithelium (RPE) and the choriocapillaris during anti-VEGF treatment. The detection rate of the flow signal in the sub-RPE increased from 50.0% at baseline and 51.2% at 12 months to 65.9% at 24 months (P = 0.013). The flow signal extending into the choriocapillaris was detected in 0% of the eyes at baseline, 9.8% of the eyes at 12 months, and 17.1% of the eyes at 24 months (P = 0.018). The presence of subretinal drusenoid deposits (SDD) was significantly more frequent in the group with extension into the choriocapillaris (100%) than in the group without (61.8%, P = 0.036). For the four eyes with extension into the choroid, the morphological feature of the lesion on en face OCTA evolved into a tangled vascular network, similar to type 1 neovascularization.

Conclusion

OCTA analysis revealed that type 3 neovascularization gradually extended downward toward the sub-RPE and choroid during anti-VEGF treatment. The extension of the lesion into the choriocapillaris, suggesting retinal-choroidal anastomosis, was significantly more frequent in eyes with SDD.

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Data availability

The data are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Kim’s Eye Hospital, Konyang University College of Medicine, 156, 4ga, Yeongdeungpo-dong, Yeongdeungpo-gu, Seoul, South Korea

    Han Joo Cho, Soo Hyun Lim, Jaemin Kim, Jihyun Lee, Dong Won Lee & Jong Woo Kim

Authors
  1. Han Joo Cho
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  2. Soo Hyun Lim
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  3. Jaemin Kim
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  4. Jihyun Lee
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  5. Dong Won Lee
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  6. Jong Woo Kim
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Contributions

Design and conduct of the study: HJC. Data collection: HJC, SHL, JK, JL, DWL, and JWK. Analysis and interpretation of data: HJC, JK, and DWL. Writing of the article: HJC. Critical revision and final approval of article: JWK

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Correspondence to Han Joo Cho.

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The study was approved by the Institutional Review Board of Kim’s Eye Hospital, Konyang University College of Medicine.

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The need for informed consent was waived by Institutional Review Board of Kim’s Eye Hospital, Konyang University College of Medicine.

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The authors declare no competing interests.

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Cho, H.J., Lim, S.H., Kim, J. et al. Assessing the long-term evolution of type 3 neovascularization in age-related macular degeneration using optical coherence tomography angiography. Graefes Arch Clin Exp Ophthalmol 259, 2605–2613 (2021). https://doi.org/10.1007/s00417-021-05163-7

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  • DOI: https://doi.org/10.1007/s00417-021-05163-7

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