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OCT angiography shows structure/function ‘disconnect’
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WAIKOLOA, Hawaii — Functional improvements in vision were not correlated with structural architecture as expected in patients with wet AMD who were treatment resistant to anti-VEGF therapy and were then pretreated with Fovista, a speaker said here.
“We appear to have an OCT/vision disconnect,” Pravin U. Dugel, MD, told colleagues at Retina 2016.
Pravin U. Dugel
Dugel said OCT showed contrary results to what he and colleagues expected in an 18-month follow-up of a small pilot study in which a letter score improvement of 15 was seen in the patients pretreated with Fovista (pegpleranib, Ophthotech).
Patients who were seen as “dry” by conventional OCT, with no leakage seen on fluorescein angiography and with flow as seen on OCT angiography all gained vision, which was not the expected result, he said.
Findings on OCT angiography showing a high flow state but no leakage suggest that normalized or hypermature vessels may be necessary for this wound healing response after the pruning of immature vessels, Dugel said.
“Luckily, because of new imaging modalities like OCT angiography, we’re going to bridge that disconnect,” Dugel said. – by Patricia Nale, ELS
Reference:
Anti-VEGF resistance in neovascular age-related macular degeneration: Role of platelet-derived growth factor antagonism. Presented at: Retina 2016; Jan. 19, 2016; Waikoloa, Hawaii.
Disclosure: Dugel reports he is a minor shareholder of and consultant to Ophthotech and a consultant to Alcon, Genentech and Novartis.