TYPE 2 NEOVASCULARIZATION SECONDARY TO AGE-RELATED MACULAR DEGENERATION IMAGED BY OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY

Purpose: Optical coherence tomography angiography is a novel and noninvasive technique for imaging retinal microvasculature by detecting changes in reflectivity that is related to blood flow. The purpose of this study was to describe Type 2 neovascularization characteristics in age-related macular degeneration using optical coherence tomography angiography. Methods: Fourteen eyes of 14 consecutive patients with Type 2 neovascularization were prospectively included. All patients underwent a complete ophthalmological examination, including color and infrared fundus photography, fluorescein and indocyanine green angiography, spectral domain optical coherence tomography angiography, and optical coherence tomography angiography. Results: In all cases, Type 2 lesions could be detected by optical coherence tomography angiography, presenting as a hyperflow lesion in the outer retina, with a glomerulus (4/14) or medusa shape (10/14), surrounded by a dark halo. The superficial layer and the deep retina showed no abnormal flow. Surprisingly, the Type 2 lesions could also be observed in the presumed choriocapillaris layer. These glomerulus- or medusa-shaped lesions were connected, in 10/14 eyes, to a thicker main branch, which seemed to continue deep into the choroidal layers. Conclusion: Optical coherence tomography angiography may be a new imaging method for the diagnosis of Type 2 neovascularization in clinical routine. However, the specificity of the features needs to be investigated in further studies.

[1]  E. Souied,et al.  Infrared features of classic choroidal neovascularisation in exudative age-related macular degeneration , 2008, British Journal of Ophthalmology.

[2]  Jesse J. Jung,et al.  The incidence of neovascular subtypes in newly diagnosed neovascular age-related macular degeneration. , 2014, American journal of ophthalmology.

[3]  P Sternberg,et al.  Well-defined subfoveal choroidal neovascular membranes in age-related macular degeneration. , 1993, Ophthalmology.

[4]  Martin F. Kraus,et al.  Split-spectrum amplitude-decorrelation angiography with optical coherence tomography , 2012, Optics express.

[5]  T. Desmettre,et al.  Types of choroidal neovascularisation in newly diagnosed exudative age-related macular degeneration , 2007, British Journal of Ophthalmology.

[6]  H. Grossniklaus,et al.  Clinicopathologic correlations of surgically excised type 1 and type 2 submacular choroidal neovascular membranes. , 1998, American journal of ophthalmology.

[7]  J. Duker,et al.  Optical coherence tomography of age-related macular degeneration and choroidal neovascularization. , 1996, Ophthalmology.

[8]  Jay S Duker,et al.  Spectral-domain optical coherence tomography angiography of choroidal neovascularization. , 2015, Ophthalmology.

[9]  W. Inhoffen,et al.  Indocyanine green angiography in classic choroidal neovascularization. , 1998, Japanese journal of ophthalmology.

[10]  K Bailey Freund,et al.  Do We Need a New Classification for Choroidal Neovascularization in Age-Related Macular Degeneration? , 2010, Retina.

[11]  J. Slakter,et al.  RETINAL ANGIOMATOUS PROLIFERATION IN AGE–RELATED MACULAR DEGENERATION , 2001, Retina.

[12]  P T de Jong,et al.  An international classification and grading system for age-related maculopathy and age-related macular degeneration , 1995 .

[13]  OCT angiography: the next era of OCT technology emerges. , 2014, Ophthalmic surgery, lasers & imaging retina.

[14]  F. Ferris,et al.  Age-related macular degeneration and blindness due to neovascular maculopathy. , 1984, Archives of ophthalmology.

[15]  G. Soubrane,et al.  Indications courantes de la photothérapie dynamique dans la dégénérescence maculaire liée à l'âge : Photothérapie dynamique , 2004 .

[16]  N. Bressler,et al.  Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: one-year results of 2 randomized clinical trials--TAP report. Treatment of age-related macular degeneration with photodynamic therapy (TAP) Study Group. , 1999, Archives of ophthalmology.