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Graefes Arch Clin Exp Ophthalmol. 2019 Mar;257(3):485-493. doi: 10.1007/s00417-018-04205-x. Epub 2018 Dec 7.

Vascular remodeling of choroidal neovascularization in older myopic patients treated with ranibizumab.

Author information

1
Ophthalmology Center for Imaging and Laser, 11 rue Antoine Bourdelle, 75015, Paris, France. sycsyc75@gmail.com.
2
Department of Ophthalmology, Paris Est University, Creteil, France. sycsyc75@gmail.com.
3
Ophthalmology Center for Imaging and Laser, 11 rue Antoine Bourdelle, 75015, Paris, France.
4
Department of Ophthalmology, Paris Est University, Creteil, France.
5
Department of Ophthalmology, Hôpital Avicenne, AP-HP and Paris 13 University, Bobigny, France.

Abstract

PURPOSE:

To investigate morphological changes in myopic choroidal neovascularization (mCNV) using optical coherence tomography-angiography (OCT-A) after treatment with ranibizumab.

METHODS:

Retrospective analysis of consecutive patients over a 24-month period. All treatment-naïve mCNV were imaged at baseline with color pictures, spectral-domain OCT and OCT-A, and fluorescein angiography in selected cases. CNV morphology was classified at baseline and at 6 months. The CNV lesion surface was also compared.

RESULTS:

Twenty-nine patients with a mean age of 70.3 ± 10.1 years were included. They received a mean number of 2.65 injections over 6 months. Best-corrected visual acuity improved from 62.2 to 68.5 letters (p = 0.004), with regression of exudation in 24 eyes (82.7%). Baseline CNV was classified into tree-in-bud (16 eyes), medusa (9 eyes), or sea-fan (4 eyes) pattern. At 6 months, no abnormal blood flow was observed in CNV in 13 eyes. Eyes with complete regression or evolution towards an indistinct pattern showed more often a complete regression of exudation than eyes with unchanged pattern (p = 0.007). The mean CNV surface significantly decreased from 0.19 to 0.08 mm2 (p < 0.0001).

CONCLUSION:

An unchanged pattern was more often associated with exudation persistence, while a complete regression or evolution towards indistinct pattern was always associated with vascular inactivity. However, variable changes in mCNV were observed after anti-VEGF. Thus, OCT-A could be more useful in the diagnosis than in the follow-up of mCNV.

KEYWORDS:

Anti-VEGF; Choroidal neovascularization; Myopia; OCT-angiography; Ranibizumab

PMID:
30535969
DOI:
10.1007/s00417-018-04205-x
[Indexed for MEDLINE]

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