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Tombolini B, Crincoli E, Sacconi R, Battista M, Fantaguzzi F, Servillo A, Bandello F, Querques G. Optical Coherence Tomography Angiography: A 2023 Focused Update on Age-Related Macular Degeneration. Ophthalmol Ther 2024; 13:449-467. [PMID: 38180632 PMCID: PMC10787708 DOI: 10.1007/s40123-023-00870-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/05/2023] [Indexed: 01/06/2024] Open
Abstract
Optical coherence tomography angiography (OCTA) has extensively enhanced our comprehension of eye microcirculation and of its associated diseases. In this narrative review, we explored the key concepts behind OCTA, as well as the most recent evidence in the pathophysiology of age-related macular degeneration (AMD) made possible by OCTA. These recommendations were updated since the publication in 2020, and are targeted for 2023. Importantly, as a future perspective in OCTA technology, we will discuss how artificial intelligence has been applied to OCTA, with a particular emphasis on its application to AMD study.
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Affiliation(s)
- Beatrice Tombolini
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Division of Head and Neck, Ophthalmology Unit, Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Emanuele Crincoli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Division of Head and Neck, Ophthalmology Unit, Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Riccardo Sacconi
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Division of Head and Neck, Ophthalmology Unit, Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Marco Battista
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Division of Head and Neck, Ophthalmology Unit, Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Federico Fantaguzzi
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Division of Head and Neck, Ophthalmology Unit, Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Andrea Servillo
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Division of Head and Neck, Ophthalmology Unit, Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Francesco Bandello
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Division of Head and Neck, Ophthalmology Unit, Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy
| | - Giuseppe Querques
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
- Division of Head and Neck, Ophthalmology Unit, Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.
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Nissen AHK, Kiilgaard HC, van Dijk EHC, Hajari JN, Huemer J, Iovino C, Schneider M, Sørensen TL, Grauslund J, Subhi Y. Exudative Progression of Treatment-Naïve Nonexudative Macular Neovascularization in Age-Related Macular Degeneration: A Systematic Review With Meta-Analyses. Am J Ophthalmol 2024; 257:46-56. [PMID: 37659600 DOI: 10.1016/j.ajo.2023.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 08/21/2023] [Accepted: 08/27/2023] [Indexed: 09/04/2023]
Abstract
PURPOSE To systematically review and report the rate of exudative progression over time in patients with nonexudative macular neovascularization (MNV) in age-related macular degeneration (AMD). DESIGN Systematic review with prevalence meta-analyses and individual participant meta-analysis. METHODS We searched 10 literature databases on March 26, 2023, for studies of consecutive patients with treatment-naïve nonexudative MNV in AMD. The primary outcome of interest was time from diagnosis to exudative progression. We conducted meta-analyses on the prevalence of exudative progression at 1 and 2 years. Where possible, we extracted individual participant data from studies and conducted an individual participant meta-analysis and explored the exudative progression using a time-to-event curve. RESULTS We identified 16 eligible studies with a total of 384 eyes with nonexudative MNV. Exudative progression had occurred in 20.9% (95% CI 13.1%-29.8%) of eyes at 1 year and in 30.7% (95% CI 21.8%-40.4%) at 2 years. Similar results were observed in the individual participant meta-analysis, showing exudative progression in 18.9% (95% CI 13.5%-26.3%) of eyes at 1 year and 31.3% (95% CI 24.2%-40.0%) at 2 years. Risk factors for a fast exudative progression were the presence of subretinal lipid globules, large MNV areas, rapid MNV growth, growth in pigment epithelium detachment height and width, appearance of a branching pattern, and development of a hyporeflective halo around the MNV. CONCLUSIONS Nonexudative MNVs in AMD are at high risk of exudative progression. Recognition of these lesions may allow for better individualized follow-up regimens in which closer monitoring may facilitate earlier diagnosis of exudative progression.
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Affiliation(s)
- Anne Helene Køllund Nissen
- From the Department of Ophthalmology, Odense University Hospital (A.H.K.N., H.C.K., J.G.), Odense, Denmark
| | - Hans Christian Kiilgaard
- From the Department of Ophthalmology, Odense University Hospital (A.H.K.N., H.C.K., J.G.), Odense, Denmark
| | - Elon H C van Dijk
- Department of Ophthalmology, Leiden University Medical Centre (E.H.C.v.D.), Leiden, the Netherlands; Department of Ophthalmology, Alrijne Hospital (E.H.C.v.D.), Leiderdorp, the Netherlands
| | - Javad Nouri Hajari
- Department of Ophthalmology, Rigshospitalet (J.N.H., M.S., Y.S.), Copenhagen, Denmark
| | - Josef Huemer
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology (J.H.), London, United Kingdom; Department of Ophthalmology and Optometry, Kepler University Hospital (J.H.), Linz, Austria
| | - Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli (C.I.), Naples, Italy
| | - Miklos Schneider
- Department of Ophthalmology, Semmelweis University (M.S.), Budapest, Hungary
| | - Torben Lykke Sørensen
- Department of Ophthalmology, Zealand University Hospital (T.L.S.), Roskilde, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen (T.L.S.), Copenhagen, Denmark
| | - Jakob Grauslund
- From the Department of Ophthalmology, Odense University Hospital (A.H.K.N., H.C.K., J.G.), Odense, Denmark; Department of Clinical Research, University of Southern Denmark (J.G., Y.S.), Odense, Denmark; Department of Ophthalmology, Vestfold Hospital Trust (J.G.), Tønsberg, Norway
| | - Yousif Subhi
- Department of Ophthalmology, Rigshospitalet (J.N.H., M.S., Y.S.), Copenhagen, Denmark; Department of Clinical Research, University of Southern Denmark (J.G., Y.S.), Odense, Denmark.
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Akkan Aydoğmuş FS, Onwuka O, Saddemi J, Lasalle CC, Ramsey DJ. Second eyes to develop neovascular age-related macular degeneration have fewer symptoms and better one-year visual outcomes. BMC Ophthalmol 2023; 23:303. [PMID: 37420309 DOI: 10.1186/s12886-023-03021-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 06/06/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND This study compares the visual and anatomical outcomes for the eyes of patients who developed sequential neovascular age-related macular degeneration (nAMD), both at the time of diagnosis and at one year after treatment. METHODS The study comprised a retrospective case series of 52 patients whose eyes were diagnosed sequentially with nAMD. All eyes were treated with three monthly loading doses of anti-vascular endothelial growth factor agents, followed by further intravitreal injections, as required. Baseline characteristics and outcomes at one year after diagnosis and initial treatment were compared between first and second eyes and included visual acuity (VA), central macular thickness (CMT), and pigment epithelial detachment (PED) height on optical coherence tomography (OCT) imaging. RESULTS VA at diagnosis was better for second eyes compared with first eyes to develop nAMD (logMAR 0.68 ± 0.51 versus logMAR 0.41 ± 0.34, P = 0.002) and remained so at one year (logMAR 0.61 ± 0.60 versus logMAR 0.42 ± 0.37, P = 0.041). Similarly, PED height at diagnosis was higher in first eyes (225 ± 176 μm versus 155 ± 144 μm, P = 0.003) and also at one year (188 ± 137 μm versus 140 ± 112 μm, P = 0.019). Whereas most patients reported symptoms at first eye diagnosis (71.2%), half as many second eyes were symptomatic (28.8%, P < 0.001). Significantly more symptomatic first eyes experienced visual distortions (32.4% versus 13.3%) or scotomas (29.4% versus 6.7%), compared with a less specific visual complaint of blurry vision (38.2% versus 80.0%, P = 0.006). CONCLUSIONS Compared with first eyes to develop nAMD, second eyes tended to have better vision, smaller PED heights, and fewer symptoms likely because monitoring permitted earlier diagnosis.
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Affiliation(s)
- F Sema Akkan Aydoğmuş
- Ophthalmology Department, Ankara Sehir Hastanesi, Üniversiteler, Çankaya, Ankara, Turkey
- Department of Ophthalmology, Lahey Hospital & Medical Center, 1 Essex Center Drive, Peabody, MA, 01960, USA
| | - Oluchukwu Onwuka
- Department of Ophthalmology, Lahey Hospital & Medical Center, 1 Essex Center Drive, Peabody, MA, 01960, USA
- Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, 02111, USA
| | - Jackson Saddemi
- Department of Ophthalmology, Lahey Hospital & Medical Center, 1 Essex Center Drive, Peabody, MA, 01960, USA
- Cooper Medical School, Rowan University, Camden, NJ, 08103, USA
| | - Claudia C Lasalle
- Department of Ophthalmology, Lahey Hospital & Medical Center, 1 Essex Center Drive, Peabody, MA, 01960, USA
| | - David J Ramsey
- Department of Ophthalmology, Lahey Hospital & Medical Center, 1 Essex Center Drive, Peabody, MA, 01960, USA.
- Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, 02111, USA.
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Wang Y, Sun J, Wu J, Jia H, Feng J, Chen J, Yan Q, Huang P, Wang F, Bo Q, Sun X. Growth of nonexudative macular neovascularization in age-related macular degeneration: an indicator of biological lesion activity. Eye (Lond) 2023; 37:2048-2054. [PMID: 36434285 PMCID: PMC10333345 DOI: 10.1038/s41433-022-02282-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 09/13/2022] [Accepted: 10/06/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To investigate the growth of nonexudative macular neovascularization (MNV) in age-related macular degeneration (AMD) using swept-source optical coherence tomography angiography (SS-OCTA). METHODS Patients with treatment-naïve nonexudative AMD in one eye and exudative AMD in the fellow eye who underwent SS-OCTA imaging for at least 12 months were retrospectively reviewed. The MNV area measurement was quantified in eyes with treatment-naïve nonexudative MNV using ImageJ for analysing the correlation between MNV growth and the onset of exudation, as well as evaluating the consistency of the MNV growth rate during the subclinical and exudative stages. Kaplan-Meier survival analysis and logistic regression analyses were used. RESULTS In total, 45 eyes with treatment-naïve nonexudative AMD from 45 patients were enrolled. Treatment-naïve nonexudative MNV was identified in 21 eyes (46.67%) at baseline. The development of exudative findings was noted in eight eyes (17.78%), including six eyes with previously noted nonexudative MNV. Eyes with growing MNV (increase in area ≥50% within 12 months) had an increased risk of exudation and developed exudation earlier than eyes with stable MNV (13.60 [6.43-20.77] months versus 31.11 [26.61-35.62] months, P < 0.0001, Log-rank test). Consistent growth pattern of MNV lesions was further identified in eyes with growing MNV during anti-VEGF treatment. CONCLUSION SS-OCTA allows to qualitatively and quantitatively evaluate nonexudative MNV in AMD patients. Growing MNV involved higher probabilities and a faster onset of exudation compared to stable MNV. Identifying the growth of MNV on OCTA might be helpful for establishing treatment strategies and follow-up planning.
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Affiliation(s)
- Yusong Wang
- National Clinical Research Center for Ophthalmic Diseases, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Junran Sun
- National Clinical Research Center for Ophthalmic Diseases, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiali Wu
- National Clinical Research Center for Ophthalmic Diseases, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huixun Jia
- National Clinical Research Center for Ophthalmic Diseases, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingyang Feng
- National Clinical Research Center for Ophthalmic Diseases, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jieqiong Chen
- National Clinical Research Center for Ophthalmic Diseases, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Quan Yan
- National Clinical Research Center for Ophthalmic Diseases, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Peirong Huang
- National Clinical Research Center for Ophthalmic Diseases, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fenghua Wang
- National Clinical Research Center for Ophthalmic Diseases, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Qiyu Bo
- National Clinical Research Center for Ophthalmic Diseases, Shanghai, China.
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Xiaodong Sun
- National Clinical Research Center for Ophthalmic Diseases, Shanghai, China.
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- National Clinical Research Center for Eye Diseases, Shanghai, China.
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China.
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China.
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FIVE-YEAR INCIDENCE OF FELLOW EYE NEOVASCULAR INVOLVEMENT IN AGE-RELATED MACULAR DEGENERATION AND POLYPOIDAL CHOROIDAL VASCULOPATHY IN AN ASIAN POPULATION. Retina 2023; 43:294-302. [PMID: 36695799 DOI: 10.1097/iae.0000000000003666] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE To assess 5-year cumulative incidence and risk factors of fellow eye involvement in Asian neovascular age-related macular degeneration (nAMD) and polypoidal choroidal vasculopathy. METHODS In a prospective cohort study of Asian nAMD and polypoidal choroidal vasculopathy, the fellow eyes were evaluated for exudation. The 5-year incidence of exudation was compared between nAMD and polypoidal choroidal vasculopathy. RESULTS A total of 488 patients were studied. The 5-year incidence of exudation in fellow eyes was 16.2% (95% confidence interval: 12.0-20.2). Polypoidal choroidal vasculopathy compared with nAMD in the first eye was associated with lower fellow eye progression (9.8% [95% confidence interval: 5.1-14.3]) vs. 22.9% [95% confidence interval: 15.8-29.3], P < 0.01). Drusen (hazards ratio 2.11 [95% confidence interval: 1.10-4.06]), shallow irregular retinal pigment epithelium elevation (2.86 [1.58-5.18]), and pigment epithelial detachment (3.01 [1.27-7.17]) were associated with greater progression. A combination of soft drusens and subretinal drusenoid deposits, and specific pigment epithelial detachment subtypes (multilobular, and sharp peaked) were associated with progression. Pigment epithelial detachment, shallow irregular retinal pigment epithelium elevation, and new subretinal hyperreflective material occurred at 10.4 ± 4.2 months, 11.1 ± 6.0 months, and 6.9 ± 4.3 months, respectively, before exudation. CONCLUSION The 5-year incidence of fellow eye involvement in Asian nAMD is lower than among Caucasians because of a higher polypoidal choroidal vasculopathy prevalence. Drusens, shallow irregular retinal pigment epithelium elevation, and pigment epithelial detachment are risk factors for fellow eye progression.
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Onwuka O, Saddemi JL, Akkan Aydoğmuş FS, Lasalle CC, Ramsey DJ. Consequences of Real-World Surveillance of Fellow Eyes in Neovascular Age-Related Macular Degeneration. Life (Basel) 2023; 13:385. [PMID: 36836742 PMCID: PMC9963142 DOI: 10.3390/life13020385] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/19/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023] Open
Abstract
This study investigated whether the interval of monitoring at-risk, fellow eyes of patients with unilateral neovascular age-related macular degeneration (nAMD) has any bearing on the severity of the disease at the time of diagnosis. The study comprised a retrospective, cross-sectional comparative case series of treatment-naïve eyes in patients who were diagnosed sequentially with nAMD. We compared the visual acuity (VA) and central macular thickness (CMT) of patients who were actively receiving intravitreal injections (IVIs) of anti-vascular endothelial growth factor (anti-VEGF) agents at the time of second eye diagnosis with the VA and CMT of patients who had ceased treatment in their first eye because of reaching end-stages of disease. Intervals of visits and frequency of monitoring the macula of fellow eyes by means of optical coherence tomography (OCT) were abstracted from the medical record. We found that the at-risk fellow eyes of patients who had stopped treatment for nAMD in their first eye prior to fellow eye conversion were monitored significantly less frequently than the fellow eyes of patients who continued to receive treatment at the time of second eye diagnosis. Despite less frequent monitoring, VA and CMT were similar at the time of fellow eye diagnosis for both groups.
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Affiliation(s)
- Oluchukwu Onwuka
- Department of Surgery, Division of Ophthalmology, Lahey Hospital and Medical Center, Beth Israel Lahey Health, Burlington, MA 01805, USA; (O.O.); (J.L.S.); (F.S.A.A.); (C.C.L.)
- Department of Ophthalmology, Tufts University School of Medicine, Boston, MA 02111, USA
| | - Jackson L. Saddemi
- Department of Surgery, Division of Ophthalmology, Lahey Hospital and Medical Center, Beth Israel Lahey Health, Burlington, MA 01805, USA; (O.O.); (J.L.S.); (F.S.A.A.); (C.C.L.)
- Cooper Medical School, Rowan University, Camden, NJ 08103, USA
| | - Fatma Sema Akkan Aydoğmuş
- Department of Surgery, Division of Ophthalmology, Lahey Hospital and Medical Center, Beth Israel Lahey Health, Burlington, MA 01805, USA; (O.O.); (J.L.S.); (F.S.A.A.); (C.C.L.)
- Ophthalmology Department, Ankara Sehir Hastanesi, Üniversiteler, Çankaya, 06800 Ankara, Turkey
| | - Claudia C. Lasalle
- Department of Surgery, Division of Ophthalmology, Lahey Hospital and Medical Center, Beth Israel Lahey Health, Burlington, MA 01805, USA; (O.O.); (J.L.S.); (F.S.A.A.); (C.C.L.)
- Department of Ophthalmology, Tufts University School of Medicine, Boston, MA 02111, USA
| | - David J. Ramsey
- Department of Surgery, Division of Ophthalmology, Lahey Hospital and Medical Center, Beth Israel Lahey Health, Burlington, MA 01805, USA; (O.O.); (J.L.S.); (F.S.A.A.); (C.C.L.)
- Department of Ophthalmology, Tufts University School of Medicine, Boston, MA 02111, USA
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Sacconi R, Fragiotta S, Sarraf D, Sadda SR, Freund KB, Parravano M, Corradetti G, Cabral D, Capuano V, Miere A, Costanzo E, Bandello F, Souied E, Querques G. Towards a better understanding of non-exudative choroidal and macular neovascularization. Prog Retin Eye Res 2023; 92:101113. [PMID: 35970724 DOI: 10.1016/j.preteyeres.2022.101113] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/14/2022] [Accepted: 08/03/2022] [Indexed: 02/01/2023]
Abstract
Non-exudative macular and choroidal neovascularization (MNV and CNV) usually refers to the entity of treatment-naïve type 1 neovascularization in the absence of associated signs of exudation. Histopathological studies, dating back in the early 70s, identified the presence of non-exudative MNV, but the first clinical report of this finding was in the late 90s using indocyanine green angiography in eyes with age-related macular degeneration (AMD). With more advanced retinal imaging, there has been an ever increasing appreciation of non-exudative MNV associated with AMD and CNV with other macular disorders. However, consensus regarding the exact definition and the clinical management of this entity is lacking. Furthermore, there may be variation in the imaging features and clinical course suggesting that a spectrum of disease may exist. Herein, we review the large body of published work that has provided a better understanding of non-exudative MNV and CNV in the last decade. The prevalence, multimodal imaging features, clinical course, and response to treatment are discussed to elucidate further key insights about this entity. Based on these observations, this review also proposes a new theory about the origin and course of different sub-types of non-exudative MNV/CNV which can have different etiologies and pathways according to the clinical context of disease.
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Affiliation(s)
- Riccardo Sacconi
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Division of Head and Neck, Ophthalmology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Serena Fragiotta
- UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy
| | - David Sarraf
- Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA, USA; Greater Los Angeles VA Healthcare Center, Los Angeles, CA, United States
| | - SriniVas R Sadda
- Doheny Eye Institute, Los Angeles, CA, United States; Department of Ophthalmology, University of California, Los Angeles, Los Angeles, CA, United States
| | - K Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, NY, United States; Department of Ophthalmology, NYU Grossman School of Medicine, New York, NY, United States
| | | | - Giulia Corradetti
- Doheny Eye Institute, Los Angeles, CA, United States; Department of Ophthalmology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Diogo Cabral
- Vitreous Retina Macula Consultants of New York, New York, NY, United States; Department of Ophthalmology, NYU Grossman School of Medicine, New York, NY, United States
| | - Vittorio Capuano
- Department of Ophthalmology, Hospital Intercommunal de Creteil, University Paris Est Creteil, Creteil, France
| | - Alexandra Miere
- Department of Ophthalmology, Hospital Intercommunal de Creteil, University Paris Est Creteil, Creteil, France
| | | | - Francesco Bandello
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Division of Head and Neck, Ophthalmology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Eric Souied
- Department of Ophthalmology, Hospital Intercommunal de Creteil, University Paris Est Creteil, Creteil, France
| | - Giuseppe Querques
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Division of Head and Neck, Ophthalmology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
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Shen M, Rosenfeld PJ, Gregori G, Wang RK. Predicting the Onset of Exudation in Treatment-Naïve Eyes with Nonexudative Age-Related Macular Degeneration. Ophthalmol Retina 2022; 6:1-3. [PMID: 34996537 DOI: 10.1016/j.oret.2021.10.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/03/2021] [Accepted: 10/11/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Mengxi Shen
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Philip J Rosenfeld
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
| | - Giovanni Gregori
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Ruikang K Wang
- Departments of Bioengineering and Ophthalmology, University of Washington, Seattle, Washington
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Outer Retinal Layer Thickening Predicts the Onset of Exudative Neovascular Age-Related Macular Degeneration. Am J Ophthalmol 2021; 231:19-27. [PMID: 34058152 DOI: 10.1016/j.ajo.2021.05.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 05/15/2021] [Accepted: 05/16/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE To assess changes in outer retinal layer (ORL) thickness before the development of exudative macular neovascularization (MNV) in eyes with age-related macular degeneration. DESIGN Retrospective observational case series. METHODS Eyes with age-related macular degeneration that eventually developed exudative MNV followed with sequential optical coherence tomography for ≥2 years before the exudation occurred were enrolled. The ORL thickness was automatically calculated by the optical coherence tomography software for each sector of the early treatment diabetic retinopathy study map at each follow-up visit. The ORL thickness change from baseline to the day when the exudative MNV developed was compared between sectors that eventually developed exudative MNV and those that did not. RESULTS Forty-seven eyes (47 patients) were included. At baseline (24 ± 3 months before exudative MNV), mean (standard deviation) ORL thickness of sectors that eventually developed exudative MNV was similar to that of sectors that did not (85.2 [8.2] µm vs 86.8 [5.7] µm, P = .08). ORL thickness significantly increased in sectors that developed exudative MNV compared with those that did not (+5.8 [10.4] µm vs -2.8 [3.6] µm, P < .01). The regression model based on these data predicted an increase in ORL thickness from baseline of +4.2% 55 days and +11.1% 30 days before exudative MNV was detected. The ORL thickness of areas that did not develop exudative MNV did not change. CONCLUSION Thickening of the ORL begins in the area where exudative MNV will develop long before the exudation, accelerating significantly in the last 2 months. The occurrence of exudative MNV could be predicted by 2 months using this simple analysis.
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Cheung CMG, Teo KYC, Tun SBB, Busoy JM, Veluchamy AB, Spaide RF. Differential reperfusion patterns in retinal vascular plexuses following increase in intraocular pressure an OCT angiography study. Sci Rep 2020; 10:16505. [PMID: 33020568 PMCID: PMC7536233 DOI: 10.1038/s41598-020-73585-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/18/2020] [Indexed: 11/09/2022] Open
Abstract
To describe patterns of reperfusion in the superficial vascular plexus (SVP), deep capillary plexus (DCP) and choriocapillaris (CC) as detected on optical coherence tomography (OCTA) in cynomogulus macaque monkey model following increase in intraocular pressure by an intravitreal injection. Animal imaging study. Two cynomogulus macaque monkeys. A 100 µL intravitreal injection (IVI) of saline was given in one eye of each monkey. Serial OCTA using a Zeiss Plex Elite 9000 was used to evaluate reperfusion patterns within the SCP, DCP, and CC. OCTA evidence of perfusion. Pulsation of the central retinal artery was detected after the intraocular pressure was elevated to 98 and ≥ 99 mmHg from IVI. Episodic flow within the SVP arterioles and venules and poor visualization of flow in capillaries was noted during the initial phase of elevated pressure. As the pressure declined, the flow signal within the DCP appeared initially as dots, which progressed laterally to loops which form capillary vortex configuration. Recovery of flow within the SVP and CC appeared sooner than in the DCP. At 40 min after the injection, well after the intraocular pressure normalized, the retinal and choriocapillaris vascular perfusion showed focal defects in every layer. Compared with pre-injection images, vessel density in the DCP was 68.8% and 78.6% of baseline in monkey 1 and monkey 2, respectively. In contrast vessel density in the SVP recovered to 84.2% and 88.9% of baseline. Increases in intraocular pressure from IVI have the potential to affect every layer of blood flow in the fundus. After nominal return of intraocular pressure, focal defects in flow persisted, which may result in longer term damage to the retina.
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Affiliation(s)
- Chui Ming Gemmy Cheung
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Ave, Singapore, 168751, Singapore. .,Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore.
| | - Kelvin Yi Chong Teo
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Ave, Singapore, 168751, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Singapore.,University of Sydney, Sydney, Australia
| | - Sai Bo Bo Tun
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Ave, Singapore, 168751, Singapore
| | - Joanna Marie Busoy
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Ave, Singapore, 168751, Singapore
| | - Amutha Barathi Veluchamy
- Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Ave, Singapore, 168751, Singapore
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