The following is a summary of “Can objective parameters in optical coherence tomography be useful markers in the treatment and follow-up of type 1 and type 2 macular neovascularizations related to neovascular age-related macular degeneration?,” published in the March 2024 issue of Ophthalmology by Ozen et al.
Researchers conducted a retrospective study comparing type 1 and type 2 macular neovascularization (MNV) responses in neovascular age-related macular degeneration (n-AMD) to intravitreal anti-vascular endothelial growth factor (VEGF) treatments using quantitative parameters from optical coherence tomography (OCT), while also evaluating their correlation with changes in best-corrected visual acuity (BCVA) and the frequency of intravitreal anti-VEGF injections over one year.
They analyzed data from 90 eyes (90 patients) diagnosed with n-AMD and treated with intravitreal anti-VEGF using the “Pro re nata” approach. OCT angiography (OCTA) images were utilized to distinguish subtypes of MNVs. Spectral-domain OCT examinations were performed to record central macular thickness (CMT), and central macular volume (CMV) values at baseline and 12-month mark. The number of intravitreal anti-VEGF injections administered during the 12-month follow-up period was also documented for each patient. Data obtained were compared across different MNV types.
The results showed that in the study of n-AMD cases, 56.66% presented with type 1 MNV and 43.34% with type 2 MNV. The mean baseline BCVA logMAR values for eyes with type 2 MNV (1.15 ± 0.43) were higher compared to those with type 1 MNV (0.76 ± 0.42) (P=0.001). The mean baseline CMT and CMV values in eyes with type 2 MNV were higher compared to those with type 1 MNV (424.89 ± 49.46 μm vs. 341.39 ± 37.06 μm; 9.17 ± 0.89 μm3 vs. 8.49 ± 0.53 μm3; P<0.05). After 12 months of treatment, the logMAR values of BCVA (0.86 ± 0.42) in patients with type 2 MNV were higher compared to those with type 1 MNV (0.57 ± 0.37) (P=0.001). Mean CMT and CMV values at the 12th month in patients with type 2 MNV (379.11 ± 46.36 μm and 8.66 ± 0.79 μm3) were observed to be higher compared to those with type 1 MNV (296.95 ± 33.96 μm and 8.01 ± 0.52 mm3) (P<0.05). Positive correlations were observed in type 2 MNVs between baseline and 12th-month BCVA logMAR values and baseline CMV (P<0.05). A positive correlation between the 12th-month BCVA logMAR values and the 12th-month CMV (P<0.05) was observed in type 2 MNVs. Additionally, the total number of intravitreal anti-VEGF injections at 12 months was similar in both groups (P=0.851).
Investigators concluded that CMT and CMV, particularly in type 2 MNV, could be better outcome measures for monitoring disease and treatment response in MNV patients due to their correlation with visual function.
Source: link.springer.com/article/10.1007/s10792-024-03073-1
