A proof of concept study to evaluate the treatment response of aflibercept in wARMD using OCT-A (Canada study).

Autor: Sodhi SK; University of Cambridge, Cambridge, UK., Trimboli C; Vitreous Retina Macula Specialists of Toronto, 3280 Bloor St. West. Suite 310, Etobicoke, ON, M8X 2X3, Canada., Kalaichandran S; Faculty of Medicine, University of Toronto, Toronto, ON, Canada., Pereira A; Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, ON, Canada., Choudhry N; Vitreous Retina Macula Specialists of Toronto, 3280 Bloor St. West. Suite 310, Etobicoke, ON, M8X 2X3, Canada. netan.choudhry@vrmto.com.; Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, ON, Canada. netan.choudhry@vrmto.com.
Jazyk: angličtina
Zdroj: International ophthalmology [Int Ophthalmol] 2021 May; Vol. 41 (5), pp. 1697-1708. Date of Electronic Publication: 2021 Feb 07.
DOI: 10.1007/s10792-021-01726-z
Abstrakt: Purpose: To Utilize OCT-A to measure the change in size (mm 2 ) and density (flow index) of choroidal neovascular membranes (CNVMs) from baseline to week 52 of treatment-naïve wet age-related macular degeneration (wARMD) patients receiving intravitreal aflibercept injections (IAI).
Methods: Patients were treated with IAI at baseline, month 1 and month 2 and then every other month for a total of 12 months. Along with clinical examination and best corrected visual acuity (BCVA), OCT-A 6- and 3-mm scans were acquired at every visit between May 2017 and January 2019. Data from baseline, week 12 and week 52 were analyzed prospectively and included in the final analysis.
Results: Twenty-five eyes from 23 patients were included in the study. The mean BCVA at baseline and week 52 increased from 20/125 to 20/80, respectively (p < 0.001). The mean CST at baseline and week 52 decreased from 330.48 to 222.40 μm, respectively (p < 0.001). 1Seventeen patients (18 eyes) completed all protocol-based 6 × 6 mm and 3 × 3 mm OCT-A scans. In this subgroup, 6-mm OCT-A scans revealed that the mean size of the CNVM before and after IAI was 1.21 mm 2 and 0.56 mm 2 , respectively (p < 0.001), while the 3-mm OCT-A scans at baseline and week 52 demonstrated a decrease in mean size of the CNVM from 0.89 to 0.37 mm 2 , respectively (p < 0.001). The 6-mm perfusion density map revealed no difference at either time points.
Conclusions: OCT-A provides a useful approach for monitoring and evaluating the treatment of intravitreal aflibercept for CNVMs. Mean size of CNVMs can be identified by 3- or 6-mm scans, but without machine learning, it requires extensive segmentation. While reproducibility and clear delineation of CNVMs in wARMD using OCT-A is challenging, OCT-A does offer the ability to monitor CNVM size changes during treatment and may offer another biomarker to assist in assessing treatment response.
Databáze: MEDLINE
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