Structural Bscan OCT correlation with OCT angiography biomarkers of activity in neovascular age related macular degeneration

Abstract

PurposeFluid on structural B scan OCT is currently the most important sign among all imaging modalities of neovascular AMD. Recently, OCT angiography biomarkers of activity of nAMD have been described. The aim of the study is to compare the appearance of OCT angiography of eyes with wAMD with intraretinal or subretinal fluid against those without fluid on Bscan OCT.MethodsRetrospective cross sectional study.Fluid on Bscan OCT was classified as intraretinal fluid such as cysts and subretinal fluid as fluid under the retina. OCT angiography biomarkers of activity of nAMD were presence of secondary small vessel branching, peripheral arcades with anastomoses and presence of a dense net (DN). Inclusion criteria were: presence of neovessels on OCT angiography and sufficent images quality on both modalities. Presence of degenerative cysts and/or PED was an exclusion criteria.Results59 eyes of 55 patients naive or treated for wet AMD were included (average age: 80 (SD ±7), min‐max: 63‐95). Subretinal fluid was present in 20% eyes (12/59), intraretinal fluid in 25% (15/59), a combination of both in 10% (6/59) and absence of subretinal or intraretinal fluid in 44% (26/59). DN was present in 30% (18/59), LN in 69% (41/59). Dense net was present in statistically significantly more of the uncontrolled eyes 45% (15/33) (p=0.009, fisher exact test.) Peripheral arcades with anastomoses were evident in 46% (12/26) of controlled eyes and 61% (20/33) of uncontrolled eyes. Small vessel branching was evident in 0% (0/26) of the controlled eyes and in 36% (12/33) uncontrolled eyes.ConclusionsDense net are significantly more prevalent in eyes with uncontrolled AMD; small vessel branching and peripheral loops are also more prevalent in these eyes. This suggest that OCT‐A provides imaging of the morphology of choroidal CNV in AMD patients associated with disease activity.