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OCT angiography quantitates differences in lesion responses to anti-VEGF therapy

Issue: May 2016

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COLORADO SPRINGS, Colo. — Type 1 neovascular lesions are large, mature and resistant to anti-VEGF therapy, whereas type 3 lesions are small capillary tufts that are highly responsive to just one anti-VEGF injection, according to a study presented here.

Using OCT angiography, David Sarraf, MD, and colleagues looked at the quantitative and qualitative effects of anti-VEGF therapy in both types of lesions in cases of age-related macular degeneration.

David Sarraf

“In this particular study, we wanted to look at the microvascular response of these lesions to anti-VEGF therapy and quantitate the reduction in area and density of these lesions,” Sarraf said at the American Ophthalmological Society meeting.

In the 11 patients in the study with type 1 lesions, Sarraf and colleagues found mean lesion area to be 6.36 mm² before therapy and 6.35 mm² after therapy.

In the 11 patients with type 3 lesions, mean area was 0.097 mm² before therapy and 0.025 mm² after therapy, an average reduction in area of 78.2%.

“Type 1 lesions are much larger ... and after anti-VEGF injection, there’s very little change in the density of these lesions, with only a 2.56% reduction,” Sarraf said. “The type 3 lesions, on the other hand, were much smaller ... and there was a substantial reduction in area, about 80%.”

Type 1 lesions originate from the choroid, whereas type 3 lesions originate from the deep capillary plexus of the retina, Sarraf said.

“OCT angiography can identify the extent and the microvascular detailed morphology of both type 1 and type 3 neovascular lesions,” Sarraf said. “Quantitative and qualitative OCT angiography may be an effective tool to assess response of neovascularization in AMD.” – by Patricia Nale, ELS

Reference:

Sarraf D. OCT angiography of type 1 versus type 3 neovascularization before and after anti-VEGF therapy in patients with AMD. Presented at: American Ophthalmological Society meeting; May 19-22, 2016; Colorado Springs, Colo.

Disclosure: Sarraf reports receiving research grants from Genentech, Regeneron and Optovue.