Correspondence of leakage on fluorescein angiography and optical coherence tomography parameters in diagnosis and monitoring of myopic choroidal neovascularization treated with bevacizumab

Maurizio Battaglia Parod, Pierluigi Iacono, Francesco Bandello

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19 Citations (Scopus)

Abstract

Purpose: To describe the morphologic alterations on spectral domain optical coherence tomography in active myopic choroidal neovascularization (CNV) receiving intravitreal bevacizumab and to evaluate its diagnostic accuracy, taking fluorescein angiography as a reference examination. Methods: Thirty patients (30 eyes) were prospectively enrolled. Each eye was imaged with fluorescein angiography and spectral domain optical coherence tomography at the baseline and at 1-, 2-, and 3-month examinations. Spectral domain optical coherence tomography parameters consisting of intraretinal/subretinal fluid and absence of external limiting membrane (ELM) visibility were considered signs of CNV activity and collated with the presence/absence of leakage on fluorescein angiography. Main outcome measures were frequencies of the retinal alterations associated with myopic CNV at the diagnosis and during monitoring of anti-vascular endothelial growth factor therapy. Results: At the diagnosis, spectral domain optical coherence tomography identified subretinal fluid in 14 eyes (46%), intraretinal fluid associated with subretinal fluid in 12 eyes (40%), and absence of ELM visibility in 30 of the 30 eyes (100%). During the follow-up, fluorescein leakage was noted in 32 visits (18, 8, and 6 eyes at the 1-, 2- and 3-month examinations, respectively). Taking into consideration spectral domain optical coherence tomography features of active myopic CNVs on fluorescein angiography, subretinal fluid was identified in 24 examinations (75%), intraretinal cysts with subretinal fluid were noted in 5 visits (15.6%), and the absence of ELM visibility was visible in 32 examinations (100%). The alterations of the ELM corresponded to the location of the fluorescein leakage. Conclusion: This study provides evidence that the absence of ELM visibility is a more reliable parameter for evaluating CNV activity than intraretinal/subretinal fluid collection and may constitute a useful option in diagnosing and monitoring the myopic CNV during antivascular endothelial growth factor therapy.

Original languageEnglish
Pages (from-to)104-109
Number of pages6
JournalRetina
Volume36
Issue number1
DOIs
Publication statusPublished - 2016

Fingerprint

Subretinal Fluid
Choroidal Neovascularization
Fluorescein Angiography
Optical Coherence Tomography
Membranes
Fluorescein
Endothelial Growth Factors
Vascular Endothelial Growth Factor A
Bevacizumab
Cysts
Outcome Assessment (Health Care)
Therapeutics

Keywords

  • Bevacizumab
  • Choroidal neovascularization
  • Fluorescein angiography
  • Myopia
  • Optical coherence tomography

ASJC Scopus subject areas

  • Ophthalmology

Cite this

@article{786aadfcaf38463ba82a5a8d7689e802,
title = "Correspondence of leakage on fluorescein angiography and optical coherence tomography parameters in diagnosis and monitoring of myopic choroidal neovascularization treated with bevacizumab",
abstract = "Purpose: To describe the morphologic alterations on spectral domain optical coherence tomography in active myopic choroidal neovascularization (CNV) receiving intravitreal bevacizumab and to evaluate its diagnostic accuracy, taking fluorescein angiography as a reference examination. Methods: Thirty patients (30 eyes) were prospectively enrolled. Each eye was imaged with fluorescein angiography and spectral domain optical coherence tomography at the baseline and at 1-, 2-, and 3-month examinations. Spectral domain optical coherence tomography parameters consisting of intraretinal/subretinal fluid and absence of external limiting membrane (ELM) visibility were considered signs of CNV activity and collated with the presence/absence of leakage on fluorescein angiography. Main outcome measures were frequencies of the retinal alterations associated with myopic CNV at the diagnosis and during monitoring of anti-vascular endothelial growth factor therapy. Results: At the diagnosis, spectral domain optical coherence tomography identified subretinal fluid in 14 eyes (46{\%}), intraretinal fluid associated with subretinal fluid in 12 eyes (40{\%}), and absence of ELM visibility in 30 of the 30 eyes (100{\%}). During the follow-up, fluorescein leakage was noted in 32 visits (18, 8, and 6 eyes at the 1-, 2- and 3-month examinations, respectively). Taking into consideration spectral domain optical coherence tomography features of active myopic CNVs on fluorescein angiography, subretinal fluid was identified in 24 examinations (75{\%}), intraretinal cysts with subretinal fluid were noted in 5 visits (15.6{\%}), and the absence of ELM visibility was visible in 32 examinations (100{\%}). The alterations of the ELM corresponded to the location of the fluorescein leakage. Conclusion: This study provides evidence that the absence of ELM visibility is a more reliable parameter for evaluating CNV activity than intraretinal/subretinal fluid collection and may constitute a useful option in diagnosing and monitoring the myopic CNV during antivascular endothelial growth factor therapy.",
keywords = "Bevacizumab, Choroidal neovascularization, Fluorescein angiography, Myopia, Optical coherence tomography",
author = "Parod, {Maurizio Battaglia} and Pierluigi Iacono and Francesco Bandello",
year = "2016",
doi = "10.1097/IAE.0000000000000684",
language = "English",
volume = "36",
pages = "104--109",
journal = "Retina",
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TY - JOUR

T1 - Correspondence of leakage on fluorescein angiography and optical coherence tomography parameters in diagnosis and monitoring of myopic choroidal neovascularization treated with bevacizumab

AU - Parod, Maurizio Battaglia

AU - Iacono, Pierluigi

AU - Bandello, Francesco

PY - 2016

Y1 - 2016

N2 - Purpose: To describe the morphologic alterations on spectral domain optical coherence tomography in active myopic choroidal neovascularization (CNV) receiving intravitreal bevacizumab and to evaluate its diagnostic accuracy, taking fluorescein angiography as a reference examination. Methods: Thirty patients (30 eyes) were prospectively enrolled. Each eye was imaged with fluorescein angiography and spectral domain optical coherence tomography at the baseline and at 1-, 2-, and 3-month examinations. Spectral domain optical coherence tomography parameters consisting of intraretinal/subretinal fluid and absence of external limiting membrane (ELM) visibility were considered signs of CNV activity and collated with the presence/absence of leakage on fluorescein angiography. Main outcome measures were frequencies of the retinal alterations associated with myopic CNV at the diagnosis and during monitoring of anti-vascular endothelial growth factor therapy. Results: At the diagnosis, spectral domain optical coherence tomography identified subretinal fluid in 14 eyes (46%), intraretinal fluid associated with subretinal fluid in 12 eyes (40%), and absence of ELM visibility in 30 of the 30 eyes (100%). During the follow-up, fluorescein leakage was noted in 32 visits (18, 8, and 6 eyes at the 1-, 2- and 3-month examinations, respectively). Taking into consideration spectral domain optical coherence tomography features of active myopic CNVs on fluorescein angiography, subretinal fluid was identified in 24 examinations (75%), intraretinal cysts with subretinal fluid were noted in 5 visits (15.6%), and the absence of ELM visibility was visible in 32 examinations (100%). The alterations of the ELM corresponded to the location of the fluorescein leakage. Conclusion: This study provides evidence that the absence of ELM visibility is a more reliable parameter for evaluating CNV activity than intraretinal/subretinal fluid collection and may constitute a useful option in diagnosing and monitoring the myopic CNV during antivascular endothelial growth factor therapy.

AB - Purpose: To describe the morphologic alterations on spectral domain optical coherence tomography in active myopic choroidal neovascularization (CNV) receiving intravitreal bevacizumab and to evaluate its diagnostic accuracy, taking fluorescein angiography as a reference examination. Methods: Thirty patients (30 eyes) were prospectively enrolled. Each eye was imaged with fluorescein angiography and spectral domain optical coherence tomography at the baseline and at 1-, 2-, and 3-month examinations. Spectral domain optical coherence tomography parameters consisting of intraretinal/subretinal fluid and absence of external limiting membrane (ELM) visibility were considered signs of CNV activity and collated with the presence/absence of leakage on fluorescein angiography. Main outcome measures were frequencies of the retinal alterations associated with myopic CNV at the diagnosis and during monitoring of anti-vascular endothelial growth factor therapy. Results: At the diagnosis, spectral domain optical coherence tomography identified subretinal fluid in 14 eyes (46%), intraretinal fluid associated with subretinal fluid in 12 eyes (40%), and absence of ELM visibility in 30 of the 30 eyes (100%). During the follow-up, fluorescein leakage was noted in 32 visits (18, 8, and 6 eyes at the 1-, 2- and 3-month examinations, respectively). Taking into consideration spectral domain optical coherence tomography features of active myopic CNVs on fluorescein angiography, subretinal fluid was identified in 24 examinations (75%), intraretinal cysts with subretinal fluid were noted in 5 visits (15.6%), and the absence of ELM visibility was visible in 32 examinations (100%). The alterations of the ELM corresponded to the location of the fluorescein leakage. Conclusion: This study provides evidence that the absence of ELM visibility is a more reliable parameter for evaluating CNV activity than intraretinal/subretinal fluid collection and may constitute a useful option in diagnosing and monitoring the myopic CNV during antivascular endothelial growth factor therapy.

KW - Bevacizumab

KW - Choroidal neovascularization

KW - Fluorescein angiography

KW - Myopia

KW - Optical coherence tomography

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DO - 10.1097/IAE.0000000000000684

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