Optical coherence tomography-angiography for monitoring neovascularisations in macular telangiectasia type 2. Issue 5 (8th June 2020)

• Record Type: Journal Article
• Authors: Tzaridis, Simone; Hess, Kristina; Friedlander, Martin; Holz, Frank G
• Is Part Of: British journal of ophthalmology. Volume 105:Issue 5(2021)
• Page Start: 735
• Page End: 740
• Publication Date: 2020-06-08
• Subjects: imaging -- retina -- neovascularisation -- macula -- degeneration; Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjophthalmol-2020-316021
• Languages: English
• ISSNs: 0007-1161

Abstract

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.