Optical Coherence Tomography-angiography as a Modern Method of Diagnostic and Monitoring Treatment Effects in Age-related Macular Degeneration in Patients Treated with anti-VEGF Intravitreal Injections As a Part of the National Health Fund Drug Prescription
Wydanie specjalne czerw 2018
str. 32 – 39
Autorzy: Anna Heinke, Katarzyna Michalska-Małecka
Klinika Okulistyki Uniwersyteckiego Centrum Klinicznego im. prof. K. Gibińskiego Śląskiego Uniwersytetu Medycznego w Katowicach
Kierownik: prof. dr hab. n. med. Ewa Mrukwa-Kominek
Purpose: To present the application of optical coherence tomography-angiography (angio-OCT) in diagnostic of age-related macular degeneration and to evaluate the flow area changes in choroidal neovascularization in patients with exudative age-related macular degeneration in response to treatment with anti-VEGF injections as a part of the National Health Drug Prescription Program.
Material and Methods: Case series of treatment-naïve patients with exudative choroidal neovascularization assessed by optical coherence tomography-angiography performed with Optovue device (XR-Avanti, Optovue) based on split-spectrum amplitude-decorrelation technology, using 3 mm x 3 mm scans centered at the macula. The timing of optical coherence tomography-angiography analysis was directly before anti-VEGF injection, after 24 hours, between 7 days and 10 days, between 12 and 18 days, and 30 days after intravitreal anti-VEGF injection. Choroidal neovascularization flow area in mm² was measured. Best-corrected visual acuity was examined.
Results: Measurements of choroidal neovascularization flow area showed rapid decrease of flow after the first 2 weeks after intravitreal anti-VEGF injection accompanied by decrease in neovascularization area, followed by increase of flow and recanalization and rebuild of choroidal neovascularization capillaries by the fourth week after intravitreal anti-VEGF injection.
Discussion: Angio-OCT could be useful to guide treatment timing of anti-VEGF injections in order to possibly achieve earlier and more permanent regression of choroidal neovascularization.
Conclusion: Optical coherence tomography-angiography analysis is a modern method allowing frequent and non-invasive monitoring of patients with choroidal neovascularization in exudative age-related macular degeneration treated with intravitreal anti-VEGF injection.