Membrane patterns in eyes with choroidal neovascularization on optical coherence tomography angiography

Abstract

Background: To evaluate morphologic patterns of choroidal neovascular membranes using optical coherence tomography angiography (OCTA) in patients with treatment-naive, continuously treated, and previously treated exudative age-related macular degeneration (AMD). Subjects: We assessed retrospectively 184 eyes of 153 patients diagnosed with type 1, type 2, and mixed-type neovascularization associated with AMD. The type of neovascularization and clinical activity were assessed by clinical examination and spectral domain optical coherence tomography (SD-OCT). Morphological patterns of neovascular membranes were categorized using en face images on the AngioVue (Optovue) OCTA system. Results: The mean age of patients was 77.9 ± 8.6 years (range, 52–96 years). The most frequently identified type of membrane morphology was well-defined in the treatment-naive group (69% of the eyes) and in eyes receiving ongoing anti-VEGF treatments (77% of the eyes). Long-filamentous morphology was the most frequent type in the previously treated group (53%), in which only 33% had a well-defined membrane. All clinically active cases had a well-defined pattern, such as a medusa or sea-fan shaped pattern, or an ill-defined pattern, and none had a long-filamentous neovascular network. Almost half of the clinically inactive cases (47%) had well- or ill-defined, identifiable membrane morphology on OCTA. A long-filamentous membrane pattern, which was consistent with chronicity of lesion, was seen only in eyes with inactive neovascularization. Conclusions: The membrane morphology on OCTA was not associated with clinical activity, except that the presence of long dilated filamentous linear vessels was associated with chronicity and lesion inactivity.