Optical coherence tomography-angiography for monitoring neovascularisations in macular telangiectasia type 2.

Abstract

PURPOSE:

To evaluate the utility of optical coherence tomography-angiography (OCT-A) for monitoring activity, progression and response to therapy of neovascularisations (NVs) secondary to macular telangiectasia type 2 (MacTel).

METHODS:

In a retrospective analysis, eyes with NVs secondary to MacTel were reviewed over a period of ≥8 months. Examinations at monthly intervals included visual acuity testing, dilated funduscopy, spectral domain-OCT and OCT-A. Eyes were treated with intravitreal VEGF (vascular endothelial growth factor)-inhibitors following a pro-re-nata (PRN) regime, and treatment decisions were based on morphological signs of activity as determined by B-scan OCT and funduscopy. Signs of neovascular activity were defined as an increase in retinal thickness, presence/increase of intraretinal/subretinal fluid and haemorrhages.

RESULTS:

A total of 19 eyes from 17 patients were analysed. Patients were evaluated over a mean period of 13.4 months (range: 8.9 to 24.2). OCT-A permitted the monitoring of both treatment effects (regression) and progression (growth) of NVs, but not neovascular activity. The growth of neovascular vessels was detectable in OCT-A before signs of activity occurred on OCT. NVs showed a progressive growth over time despite PRN-treatment and preferentially grew and extended within areas characterised by a focal reduction of choriocapillaris perfusion.

CONCLUSIONS:

The results indicate that OCT-A represents a useful imaging modality for monitoring NV-progression and treatment effects in MacTel. We demonstrate its advantages over conventional B-scan OCT imaging, including an earlier detection of NV-progression, and propose an adjustment of the current OCT-controlled PRN treatment regime in order to prevent NV-progression and subsequent functional loss in neovascular MacTel.

• Authors: Simone Tzaridis, Kristina Hess, Martin Friedlander, Frank G Holz
• Journal: The British journal of ophthalmology (Br J Ophthalmol) Vol. 105 Issue 5 Pg. 735-740 (05 2021) ISSN: 1468-2079 [Electronic] England
• PMID: 32513667 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Topics

• Aged
• Female
• Fluorescein Angiography (methods)
• Follow-Up Studies
• Fundus Oculi
• Humans
• Macula Lutea (pathology)
• Male
• Middle Aged
• Retinal Neovascularization (diagnosis, etiology)
• Retinal Pigment Epithelium (pathology)
• Retinal Telangiectasis (complications, diagnosis)
• Retrospective Studies
• Tomography, Optical Coherence (methods)
• Visual Acuity