Optical Coherence Tomography Angiography of Asymptomatic Neovascularization in Intermediate Age-Related Macular Degeneration

Luiz Roisman, Qinqin Zhang, Ruikang K. Wang, Giovanni Gregori, Anqi Zhang, Chieh Li Chen, Mary K. Durbin, Lin An, Paul F. Stetson, Gillian Robbins, Andrew Miller, Fang Zheng, Philip J Rosenfeld

Research output: Contribution to journalArticle

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Abstract

Purpose: To determine whether angiography with swept-source (SS) optical coherence tomography (OCT) identifies subclinical type 1 neovascularization in asymptomatic eyes with intermediate age-related macular degeneration (iAMD). Design: Prospective, observational, consecutive case series. Participants: Patients with asymptomatic iAMD in one eye and neovascular age-related macular degeneration (AMD) in their fellow eye. Methods: The patients underwent SS OCT angiography (OCTA), fluorescein angiography (FA), and indocyanine green angiography (ICGA), and the images from these 3 angiographic techniques were compared. Main Outcome Measures: Identification of subclinical type 1 neovascularization with SS OCTA in asymptomatic eyes with iAMD. Results: Eleven consecutive patients with iAMD in one eye and neovascular AMD in their fellow eye were imaged with FA, ICGA, and SS OCTA between August 2014 and September 2015. Clinical examination of the 11 eyes revealed drusen and pigmentary abnormalities in the central macula and no evidence of macular fluid on routine OCT imaging. Ten of the 11 eyes had no evidence of leakage on FA and 1 eye had questionable fluorescein leakage. Indocyanine green angiography revealed the presence of central macular plaques in 3 of the 11 asymptomatic eyes with iAMD, and SS OCTA revealed unambiguous type 1 neovascularization corresponding to the plaques in all 3 eyes. Optical coherence tomography angiography did not identify neovascularization in the remaining 8 eyes. Conclusions: Swept-source OCTA identified type 1 neovascularization corresponding to ICGA plaques in asymptomatic eyes with iAMD. The ability of OCTA to provide noninvasive, fast, detailed, depth-resolved identification of nonexudative neovascular lesions in eyes with iAMD suggests the need for a new classification system that distinguishes between neovascular and nonneovascular iAMD.

Original languageEnglish (US)
JournalOphthalmology
DOIs
StateAccepted/In press - Oct 27 2015

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Optical Coherence Tomography
Macular Degeneration
Angiography
Indocyanine Green
Fluorescein Angiography
Fluorescein

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Optical Coherence Tomography Angiography of Asymptomatic Neovascularization in Intermediate Age-Related Macular Degeneration. / Roisman, Luiz; Zhang, Qinqin; Wang, Ruikang K.; Gregori, Giovanni; Zhang, Anqi; Chen, Chieh Li; Durbin, Mary K.; An, Lin; Stetson, Paul F.; Robbins, Gillian; Miller, Andrew; Zheng, Fang; Rosenfeld, Philip J.

In: Ophthalmology, 27.10.2015.

Research output: Contribution to journalArticle

Roisman, Luiz ; Zhang, Qinqin ; Wang, Ruikang K. ; Gregori, Giovanni ; Zhang, Anqi ; Chen, Chieh Li ; Durbin, Mary K. ; An, Lin ; Stetson, Paul F. ; Robbins, Gillian ; Miller, Andrew ; Zheng, Fang ; Rosenfeld, Philip J. / Optical Coherence Tomography Angiography of Asymptomatic Neovascularization in Intermediate Age-Related Macular Degeneration. In: Ophthalmology. 2015.
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abstract = "Purpose: To determine whether angiography with swept-source (SS) optical coherence tomography (OCT) identifies subclinical type 1 neovascularization in asymptomatic eyes with intermediate age-related macular degeneration (iAMD). Design: Prospective, observational, consecutive case series. Participants: Patients with asymptomatic iAMD in one eye and neovascular age-related macular degeneration (AMD) in their fellow eye. Methods: The patients underwent SS OCT angiography (OCTA), fluorescein angiography (FA), and indocyanine green angiography (ICGA), and the images from these 3 angiographic techniques were compared. Main Outcome Measures: Identification of subclinical type 1 neovascularization with SS OCTA in asymptomatic eyes with iAMD. Results: Eleven consecutive patients with iAMD in one eye and neovascular AMD in their fellow eye were imaged with FA, ICGA, and SS OCTA between August 2014 and September 2015. Clinical examination of the 11 eyes revealed drusen and pigmentary abnormalities in the central macula and no evidence of macular fluid on routine OCT imaging. Ten of the 11 eyes had no evidence of leakage on FA and 1 eye had questionable fluorescein leakage. Indocyanine green angiography revealed the presence of central macular plaques in 3 of the 11 asymptomatic eyes with iAMD, and SS OCTA revealed unambiguous type 1 neovascularization corresponding to the plaques in all 3 eyes. Optical coherence tomography angiography did not identify neovascularization in the remaining 8 eyes. Conclusions: Swept-source OCTA identified type 1 neovascularization corresponding to ICGA plaques in asymptomatic eyes with iAMD. The ability of OCTA to provide noninvasive, fast, detailed, depth-resolved identification of nonexudative neovascular lesions in eyes with iAMD suggests the need for a new classification system that distinguishes between neovascular and nonneovascular iAMD.",
author = "Luiz Roisman and Qinqin Zhang and Wang, {Ruikang K.} and Giovanni Gregori and Anqi Zhang and Chen, {Chieh Li} and Durbin, {Mary K.} and Lin An and Stetson, {Paul F.} and Gillian Robbins and Andrew Miller and Fang Zheng and Rosenfeld, {Philip J}",
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AU - Roisman, Luiz

AU - Zhang, Qinqin

AU - Wang, Ruikang K.

AU - Gregori, Giovanni

AU - Zhang, Anqi

AU - Chen, Chieh Li

AU - Durbin, Mary K.

AU - An, Lin

AU - Stetson, Paul F.

AU - Robbins, Gillian

AU - Miller, Andrew

AU - Zheng, Fang

AU - Rosenfeld, Philip J

PY - 2015/10/27

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N2 - Purpose: To determine whether angiography with swept-source (SS) optical coherence tomography (OCT) identifies subclinical type 1 neovascularization in asymptomatic eyes with intermediate age-related macular degeneration (iAMD). Design: Prospective, observational, consecutive case series. Participants: Patients with asymptomatic iAMD in one eye and neovascular age-related macular degeneration (AMD) in their fellow eye. Methods: The patients underwent SS OCT angiography (OCTA), fluorescein angiography (FA), and indocyanine green angiography (ICGA), and the images from these 3 angiographic techniques were compared. Main Outcome Measures: Identification of subclinical type 1 neovascularization with SS OCTA in asymptomatic eyes with iAMD. Results: Eleven consecutive patients with iAMD in one eye and neovascular AMD in their fellow eye were imaged with FA, ICGA, and SS OCTA between August 2014 and September 2015. Clinical examination of the 11 eyes revealed drusen and pigmentary abnormalities in the central macula and no evidence of macular fluid on routine OCT imaging. Ten of the 11 eyes had no evidence of leakage on FA and 1 eye had questionable fluorescein leakage. Indocyanine green angiography revealed the presence of central macular plaques in 3 of the 11 asymptomatic eyes with iAMD, and SS OCTA revealed unambiguous type 1 neovascularization corresponding to the plaques in all 3 eyes. Optical coherence tomography angiography did not identify neovascularization in the remaining 8 eyes. Conclusions: Swept-source OCTA identified type 1 neovascularization corresponding to ICGA plaques in asymptomatic eyes with iAMD. The ability of OCTA to provide noninvasive, fast, detailed, depth-resolved identification of nonexudative neovascular lesions in eyes with iAMD suggests the need for a new classification system that distinguishes between neovascular and nonneovascular iAMD.

AB - Purpose: To determine whether angiography with swept-source (SS) optical coherence tomography (OCT) identifies subclinical type 1 neovascularization in asymptomatic eyes with intermediate age-related macular degeneration (iAMD). Design: Prospective, observational, consecutive case series. Participants: Patients with asymptomatic iAMD in one eye and neovascular age-related macular degeneration (AMD) in their fellow eye. Methods: The patients underwent SS OCT angiography (OCTA), fluorescein angiography (FA), and indocyanine green angiography (ICGA), and the images from these 3 angiographic techniques were compared. Main Outcome Measures: Identification of subclinical type 1 neovascularization with SS OCTA in asymptomatic eyes with iAMD. Results: Eleven consecutive patients with iAMD in one eye and neovascular AMD in their fellow eye were imaged with FA, ICGA, and SS OCTA between August 2014 and September 2015. Clinical examination of the 11 eyes revealed drusen and pigmentary abnormalities in the central macula and no evidence of macular fluid on routine OCT imaging. Ten of the 11 eyes had no evidence of leakage on FA and 1 eye had questionable fluorescein leakage. Indocyanine green angiography revealed the presence of central macular plaques in 3 of the 11 asymptomatic eyes with iAMD, and SS OCTA revealed unambiguous type 1 neovascularization corresponding to the plaques in all 3 eyes. Optical coherence tomography angiography did not identify neovascularization in the remaining 8 eyes. Conclusions: Swept-source OCTA identified type 1 neovascularization corresponding to ICGA plaques in asymptomatic eyes with iAMD. The ability of OCTA to provide noninvasive, fast, detailed, depth-resolved identification of nonexudative neovascular lesions in eyes with iAMD suggests the need for a new classification system that distinguishes between neovascular and nonneovascular iAMD.

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