Evaluation of choroidal neovascularization with indocyanine green angiography in neovascular age-related macular degeneration subjects undergoing intravitreal bevacizumab therapy.
OBJECTIVE
To report the clinical implications of interval changes in choroidal neovascularization (CNV) size measured by indocyanine green (ICG) angiography in neovascular age-related macular degeneration (AMD) patients undergoing intravitreal bevacizumab therapy.


METHODS
Retrospective, consecutive chart review.


METHODS
The charts of neovascular AMD patients who underwent intravitreal bevacizumab therapy using a treat-and-extend dosing schedule were reviewed. ICG angiographic CNV surface areas were measured at baseline, 2 months, 6 months, and 12 months in each subject. The primary outcome was change in CNV size. Secondary outcomes included the correlation of change in CNV surface area with change in best-corrected visual acuity (BCVA), change in central macular thickness on optical coherence tomography (OCT), and the number of injections delivered over the 12-month study interval.


RESULTS
A total of 123 subjects were included in the analysis. The baseline CNV size was 1.9 mm2±2.5 mm2. CNV size was 1.66 mm2±2.11 mm2 at 2 months, 1.60 mm2±2.23 mm2 at 6 months, and 1.50 mm2±2.12 mm2 at 12 months. The change in CNV size from baseline was not statistically significant at any of the follow-up intervals. A decrease in CNV size of 33% or more at 2 months was associated with a significant decrease in CNV size at 12 months (P=.0096), complete resolution of CNV at 12 months (P=.0013), and a decrease in the number of injections delivered over the study interval (P=.0165). Complete resolution of CNV at 12 months occurred in 7.3% of subjects. Subjects that had complete resolution of CNV at 12 months were significantly more likely to gain 3 more lines of BCVA at the end of the study interval (P=.0131). No significant correlation was found between CNV size and change in central macular thickness on OCT.


CONCLUSIONS
Our study suggests that change in CNV size on ICG angiography may help the clinician predict the clinical course of neovascular AMD subjects undergoing intravitreal bevacizumab therapy using a treat-and-extend dosing schedule.
Southwest Retina Specialists, Amarillo, Texas; Panhandle Eye Group, Amarillo, Texas; Texas Tech University Health Science Center, Amarillo, Texas. Electronic address: Ryanbradfordrush21@hotmail.com.
Ryan B
RB
Rush
Panhandle Eye Group, Amarillo, Texas; Texas Tech University Health Science Center, Amarillo, Texas.
Sloan W
SW
Rush
Southwest Retina Specialists, Amarillo, Texas; Panhandle Eye Group, Amarillo, Texas; Texas Tech University Health Science Center, Amarillo, Texas.
Antonio V
AV
Aragon
Southwest Retina Specialists, Amarillo, Texas; Panhandle Eye Group, Amarillo, Texas; Texas Tech University Health Science Center, Amarillo, Texas.
J Edward
JE
Ysasaga
D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D020256:Choroidal Neovascularization / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D004396:Coloring Agents; D004305:Dose-Response Relationship, Drug; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods*; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D007208:Indocyanine Green; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity
D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D004396:Coloring Agents; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D007208:Indocyanine Green