Abstract
We investigated the association of visual outcome in typical neovascular age-related macular degeneration (nAMD) and polypoidal choroidal vasculopathy (PCV) with or without pachychoroid with lesion areas on optical coherence tomography (OCT) quantified by convolutional neural network (CNN) analysis. Treatment-naïve 132 nAMD and 45 PCV eyes treated with ranibizumab or aflibercept for at least 12 months were retrospectively reviewed. Significant factors, including intraretinal fluid (IRF), subretinal fluid (SRF), pigment epithelial detachment (PED) and subretinal hyperreflective material (SHRM) area quantified by CNN at baseline and 12 months, were analyzed by logistic regression analyses for 3-line visual gain or maintenance of 20/30 Snellen vision. Visual gain at the final visit in nAMD was associated with a smaller SHRM at baseline (OR 0.167, P = 0.03), greater decrease in SRF and SHRM from baseline to month 12 (OR 1.564, P = 0.02; OR 12.877, P = 0.01, respectively). Visual gain in nAMD without pachychoroid was associated with a greater decrease in SRF and SHRM (OR 1.574, P = 0.03, OR 1.775, P = 0.04). No association was found in nAMD with pachychoroid and any type of PCV. Greater decrease in SRF and SHRM from baseline to month 12 was associated with favorable visual outcomes in nAMD without pachychoroid but not in nAMD with pachychoroid and PCV.
Highlights
We investigated the association of visual outcome in typical neovascular age-related macular degeneration and polypoidal choroidal vasculopathy (PCV) with or without pachychoroid with lesion areas on optical coherence tomography (OCT) quantified by convolutional neural network (CNN) analysis
Among the 4 segmented lesions, the baseline areas of subretinal fluid (SRF) and pigment epithelial detachment (PED) were significantly smaller in typical neovascular age-related macular degeneration (nAMD) than in PCV, while intraretinal fluid (IRF) and subretinal hyperreflective material (SHRM) showed no differences at baseline (Supplementary Table S1)
Comparisons of the areas of 4 lesions between typical nAMD with and without pachychoroid revealed that the areas of IRF at baseline and month 12 were significantly smaller in typical nAMD with pachychoroid (Supplementary Table S2)
Summary
We investigated the association of visual outcome in typical neovascular age-related macular degeneration (nAMD) and polypoidal choroidal vasculopathy (PCV) with or without pachychoroid with lesion areas on optical coherence tomography (OCT) quantified by convolutional neural network (CNN) analysis. Significant factors, including intraretinal fluid (IRF), subretinal fluid (SRF), pigment epithelial detachment (PED) and subretinal hyperreflective material (SHRM) area quantified by CNN at baseline and 12 months, were analyzed by logistic regression analyses for 3-line visual gain or maintenance of 20/30 Snellen vision. We measured the area of IRF, SRF, PED and SHRM in typical nAMD and PCV at baseline and 12 months after the initial treatment with either ranibizumab or aflibercept using an automated segmentation algorithm. We analyzed the prognostic factors, including these anatomical parameters at baseline and 12 months, associated with visual improvement
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