OCT-A may be able to shed light on exudation recurrence in neovascular AMD.

OCT-A may be able to shed light on exudation recurrence in neovascular AMD. Photo: Steven Ferrucci, OD, and Jay M. Haynie, OD. Click image to enlarge.


To learn more about the macular neovascularization (MNV) characteristics that may help predict exudation recurrence, researchers recently conducted a retrospective analysis of patients with type one neovascular AMD. They found that using consecutive OCT-A images to identify the number of open-ended vessels could help determine which patients are at risk of recurrence.

This retrospective analysis included 291 OCT-A images obtained during consecutive visits of 45 patients with newly diagnosed type one neovascular AMD who had been treated with intravitreal anti-VEGF injections and a PRN therapy regimen. The patients were divided into two subgroups based on the exudation recurrence time from the third intravitreal injection (group one: ≤three months vs. group two: >three months).

Data showed that the MNV area and length, as well as the number of total internal branching and open-ended vessels, decreased during intravitreal anti-VEGF injection and increased at exudation recurrence. A subgroup analysis revealed that the number of total open-ended vessels increased at two months prior to exudation recurrence among patients in the late recurrence cohort (group two).

Additionally, the researchers reported that a higher total number of open-ended vessels at baseline were associated with early recurrence (group one). These findings support a link between the amount of open-ended vessels in the lesion periphery of MNV patients in the treatment-naïve state and earlier recurrence of exudation, according to the study authors.

“A consecutive analysis suggested the number of open-ended vessels in the lesion periphery to be an active marker of exudation, preceding changes that result in exudation recurrence,” they concluded. “Serial MNV observations in the treatment-naïve state and during [intravitreal anti-VEGF injection] treatment could be a useful method for treatment decision-making and surveillance.”

Choi M, Kim SW, Yun C, et al. Predictive role of optical coherence tomography angiography for exudation recurrence in patients with type 1 neovascular age-related macular degeneration treated with pro-re-nata protocol. Eye (Lond). January 7, 2022. [Epub ahead of print].