The long-term effects of anti-vascular endothelial growth factor therapy on the optical coherence tomography angiographic appearance of neovascularization in age-related macular degeneration
Abstract Background The short-term effects of anti-vascular endothelial growth factor (anti-VEGF) treatment on macular neovascularization (MNV) morphology is well described, but long-term studies on morphologic changes and correlation of such changes...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BioMed Central
2021
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| Online Access: | https://hdl.handle.net/1721.1/131591 |
| _version_ | 1811073441930936320 |
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| author | Levine, Emily S Custo Greig, Eugenia Mendonça, Luísa S M Gulati, Shilpa Despotovic, Ivana N Alibhai, A. Y Moult, Eric Muakkassa, Nora Quaranta-El Maftouhi, Maddalena El Maftouhi, Adil Chakravarthy, Usha Fujimoto, James G Baumal, Caroline R Witkin, Andre J Duker, Jay S Hartnett, M. E Waheed, Nadia K |
| author2 | Massachusetts Institute of Technology. Department of Electrical Engineering and Computer Science |
| author_facet | Massachusetts Institute of Technology. Department of Electrical Engineering and Computer Science Levine, Emily S Custo Greig, Eugenia Mendonça, Luísa S M Gulati, Shilpa Despotovic, Ivana N Alibhai, A. Y Moult, Eric Muakkassa, Nora Quaranta-El Maftouhi, Maddalena El Maftouhi, Adil Chakravarthy, Usha Fujimoto, James G Baumal, Caroline R Witkin, Andre J Duker, Jay S Hartnett, M. E Waheed, Nadia K |
| author_sort | Levine, Emily S |
| collection | MIT |
| description | Abstract
Background
The short-term effects of anti-vascular endothelial growth factor (anti-VEGF) treatment on macular neovascularization (MNV) morphology is well described, but long-term studies on morphologic changes and correlation of such changes to the type of MNV have not been conducted. This study aims to determine if different types of MNVs in neovascular AMD (nAMD) behave differently with anti-VEGF treatment as visualized on optical coherence tomography angiography (OCTA).
Methods
Treatment-naïve nAMD patients were retrospectively screened for baseline and follow-up OCTA imaging 10 or more months after initial treatment. Images were graded for MNV type, area, activity, mature versus immature vessels, vessel density, presence of atrophy, atrophy location and area. Growth rate was calculated as the percent change in lesion area from baseline over the years of follow-up. In addition, the occurrence of complete regression and the percent of lesions that grew, remained stable, and shrunk per type was also evaluated.
Results
Forty-three eyes from 43 patients with a mean follow-up of 2 years were evaluated. On structural OCT, 26 lesions were classified as pure type 1 MNVs, 12 MNVs had a type 2 component, and 5 MNVs had a type 3 component. Of these cases, 2 mixed-type MNVs were considered to have completely regressed. There was no significant differences in MNV area and growth rate between type 1 and type 2 lesions, but all cases of type 3 lesions shrunk in the follow-up period. There was no correlation between the number of injections per year and growth rate, endpoint MNV area or endpoint activity status for any MNV type. There was no significant association between the development of atrophy and the number of injections, baseline MNV area, baseline vessel density, or lesion growth rate.
Conclusions
In nAMD, complete regression of an MNV network exposed to anti-VEGF is rare. This work emphasizes the role of anti-VEGF as anti-leakage rather than vascular regression agents in nAMD. |
| first_indexed | 2024-09-23T09:33:10Z |
| format | Article |
| id | mit-1721.1/131591 |
| institution | Massachusetts Institute of Technology |
| language | English |
| last_indexed | 2024-09-23T09:33:10Z |
| publishDate | 2021 |
| publisher | BioMed Central |
| record_format | dspace |
| spelling | mit-1721.1/1315912023-09-06T20:57:28Z The long-term effects of anti-vascular endothelial growth factor therapy on the optical coherence tomography angiographic appearance of neovascularization in age-related macular degeneration Levine, Emily S Custo Greig, Eugenia Mendonça, Luísa S M Gulati, Shilpa Despotovic, Ivana N Alibhai, A. Y Moult, Eric Muakkassa, Nora Quaranta-El Maftouhi, Maddalena El Maftouhi, Adil Chakravarthy, Usha Fujimoto, James G Baumal, Caroline R Witkin, Andre J Duker, Jay S Hartnett, M. E Waheed, Nadia K Massachusetts Institute of Technology. Department of Electrical Engineering and Computer Science Massachusetts Institute of Technology. Research Laboratory of Electronics Abstract Background The short-term effects of anti-vascular endothelial growth factor (anti-VEGF) treatment on macular neovascularization (MNV) morphology is well described, but long-term studies on morphologic changes and correlation of such changes to the type of MNV have not been conducted. This study aims to determine if different types of MNVs in neovascular AMD (nAMD) behave differently with anti-VEGF treatment as visualized on optical coherence tomography angiography (OCTA). Methods Treatment-naïve nAMD patients were retrospectively screened for baseline and follow-up OCTA imaging 10 or more months after initial treatment. Images were graded for MNV type, area, activity, mature versus immature vessels, vessel density, presence of atrophy, atrophy location and area. Growth rate was calculated as the percent change in lesion area from baseline over the years of follow-up. In addition, the occurrence of complete regression and the percent of lesions that grew, remained stable, and shrunk per type was also evaluated. Results Forty-three eyes from 43 patients with a mean follow-up of 2 years were evaluated. On structural OCT, 26 lesions were classified as pure type 1 MNVs, 12 MNVs had a type 2 component, and 5 MNVs had a type 3 component. Of these cases, 2 mixed-type MNVs were considered to have completely regressed. There was no significant differences in MNV area and growth rate between type 1 and type 2 lesions, but all cases of type 3 lesions shrunk in the follow-up period. There was no correlation between the number of injections per year and growth rate, endpoint MNV area or endpoint activity status for any MNV type. There was no significant association between the development of atrophy and the number of injections, baseline MNV area, baseline vessel density, or lesion growth rate. Conclusions In nAMD, complete regression of an MNV network exposed to anti-VEGF is rare. This work emphasizes the role of anti-VEGF as anti-leakage rather than vascular regression agents in nAMD. 2021-09-20T17:28:51Z 2021-09-20T17:28:51Z 2020-08-20 2020-08-23T03:17:44Z Article http://purl.org/eprint/type/JournalArticle https://hdl.handle.net/1721.1/131591 International Journal of Retina and Vitreous. 2020 Aug 20;6(1):39 PUBLISHER_CC en https://doi.org/10.1186/s40942-020-00242-z Creative Commons Attribution https://creativecommons.org/licenses/by/4.0/ The Author(s) application/pdf BioMed Central BioMed Central |
| spellingShingle | Levine, Emily S Custo Greig, Eugenia Mendonça, Luísa S M Gulati, Shilpa Despotovic, Ivana N Alibhai, A. Y Moult, Eric Muakkassa, Nora Quaranta-El Maftouhi, Maddalena El Maftouhi, Adil Chakravarthy, Usha Fujimoto, James G Baumal, Caroline R Witkin, Andre J Duker, Jay S Hartnett, M. E Waheed, Nadia K The long-term effects of anti-vascular endothelial growth factor therapy on the optical coherence tomography angiographic appearance of neovascularization in age-related macular degeneration |
| title | The long-term effects of anti-vascular endothelial growth factor therapy on the optical coherence tomography angiographic appearance of neovascularization in age-related macular degeneration |
| title_full | The long-term effects of anti-vascular endothelial growth factor therapy on the optical coherence tomography angiographic appearance of neovascularization in age-related macular degeneration |
| title_fullStr | The long-term effects of anti-vascular endothelial growth factor therapy on the optical coherence tomography angiographic appearance of neovascularization in age-related macular degeneration |
| title_full_unstemmed | The long-term effects of anti-vascular endothelial growth factor therapy on the optical coherence tomography angiographic appearance of neovascularization in age-related macular degeneration |
| title_short | The long-term effects of anti-vascular endothelial growth factor therapy on the optical coherence tomography angiographic appearance of neovascularization in age-related macular degeneration |
| title_sort | long term effects of anti vascular endothelial growth factor therapy on the optical coherence tomography angiographic appearance of neovascularization in age related macular degeneration |
| url | https://hdl.handle.net/1721.1/131591 |
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