Quantitative optical coherence tomography angiography of choroidal neovascularization in age-related macular degeneration

By Yali Jia, Steven T. Bailey, David J. Wilson, O. Tan, M. Klein, C. Flaxel, B. Potsaid, J. Liu, Chen D. Lu, Martin F. Kraus and 2 more. Ophthalmology (Rochester, Minn.), 2014

722 citations recorded by the source corpus.

Purpose To detect and quantify choroidal neovascularization (CNV) in age-related macular degeneration (AMD) patients using optical coherence tomography (OCT) angiography. Design Observational, cross-sectional study. Participants Five normal subjects and five neovascular AMD patients were included. Methods Five eyes with neovascular AMD and five normal age-matched controls were scanned by a high-speed (100,000 A-scans/sec) 1050 nm wavelength swept-source OCT. The macular angiography scan covered a 3×3 mm area and comprised 200×200×8 A-scans acquired in 3.5 sec. Flow was detected using the split-spectrum amplitude-decorrelation angiography (SSADA) algorithm. Motion artifacts were removed by three dimensional (3D) orthogonal registration and merging of 4 scans. The 3D angiography was segmented into 3 layers: inner retina (to show retinal vasculature), outer retina (to identify CNV), and choroid. En face maximum projection was used to obtain 2D angiograms from the 3 layers. CNV area and flow index were computed from the en face OCT angiogram of the outer retinal layer. Flow (decorrelation) and structural data were combined in composite color angiograms for both en face and cross-sectional views. Main Outcome Measurements CNV angiogram, CNV area, and CNV flow index. Results En face OCT angiograms of CNVs showed sizes and locations that were confirmed by fluorescein angiography. OCT angiography provided more distinct vascular network patterns that were less obscured by subretinal hemorrhage. The en face angiograms also showed areas of reduced choroidal flow adjacent to the CNV in all cases and significantly reduced retinal flow in one case. Cross-sectional angiograms were used to visualize CNV location relative to the retinal pigment epithelium and Bruch’s layer and classify type I and type II CNV. A feeder vessel could be identified in one case. Higher flow indexes were associated with larger CNV and type II CNV. Conclusions OCT angiography provides depth-resolved information and detailed images of CNV in neovascular AMD. Quantitative information regarding CNV flow and area can be obtained. Further studies are needed to assess the role of quantitative OCT angiography in the evaluation and treatment of neovascular AMD.

Subfields: Biomedical Engineering, Ophthalmology, Radiology, Nuclear Medicine and Imaging

View Paper: https://www.semanticscholar.org/paper/013b91b61dae848ee923eaf8199f5a2b9626a839

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Citations in the corpus

Optical Coherence Tomography Angiography (2016, methodology): “pathologic neovascular net identified on the en face OCT angiogram.(61) In proliferative diabetic retinopathy, the area is of neovascularization above the ILM or optic nerve head.”
Quantitative optical coherence tomography angiography of vascular abnormalities in the living human eye (2015, methodology): “However, the visualization of intraretinal and subretinal fluid accumulation on structural OCT may provide information associated with fluid leakage (40), whereas CNV activity may be evaluated by assessing the presence or characteristics of its perfusion (24).”
Optical coherence tomography angiography: A comprehensive review of current methods and clinical applications (2017, background): “They demonstrated that multiple sclerosis patients with a history of optic neuritis had a reduced disc flow index compared to patients with multiple sclerosis that did not have an optic neuritis history as well as normal controls (Wang, Jia et al. 2014).”
Optical coherence tomography angiography (2017, background): “Abbreviations AF Autofluorescence AMD Age-related macular degeneration CCD Charge-coupled device CME Cystoid macular edema CMOS Complementary metal oxide semiconductor CNV Choroidal neovascularization CRORA Complete loss of the RPE and outer retina FA Fluorescein angiography ICG Indocyanine green IC”