title: Fluorescein angiography and spectral-domain optical coherence tomography for monitoring anti-VEGF therapy in myopic choroidal neovascularization.
abstract: OBJECTIVE
  To evaluate the agreement between fluorescein angiography (FA) and spectral-domain optical coherence tomography (SD-OCT) in detecting myopic choroidal neovascularization (CNV) activity during bevacizumab treatment.
  
  
  METHODS
  Thirty-four patients with subfoveal myopic CNV were prospectively enrolled. FA and SD-OCT were performed at baseline and at all planned monthly visits. After the first injection, additional treatments were administered following detection of fluid on SD-OCT and/or leakage on FA. κ-Analysis was performed to examine the agreement between FA and SD-OCT.
  
  
  RESULTS
  At baseline, FA and SD-OCT agreed in 26/34 cases (κ=0.23); sensitivity and specificity were 77.4 and 66.7%, respectively. Seven eyes presented leakage on FA with no fluid on SD-OCT, 1 case showed intraretinal fluid on SD-OCT and no leakage on FA. At the 1-month examination, specificity and κ-value improved, and 30/34 cases showed complete concordance. At the 3- and 4-month examinations, a discordance was noted in 6 cases. From the 5-month examination on, a correspondence was achieved in at least 30/34 cases and reached a perfect match in 11 sessions.
  
  
  CONCLUSIONS
  Our study confirms the key role of FA in diagnosing myopic CNV. It seems possible there may be a role for SD-OCT in assisting FA to monitor the myopic CNV activity during anti-vascular endothelial growth factor antibody treatment.
authors.affiliation: G.B. Bietti Foundation for Ophthalmology, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Iacono
authors.forename: Maurizio
authors.initials: M
authors.lastname: Battaglia Parodi
authors.forename: Alexandros
authors.initials: A
authors.lastname: Papayannis
authors.forename: Stylianos
authors.initials: S
authors.lastname: Kontadakis
authors.forename: Stefano
authors.initials: S
authors.lastname: Da Pozzo
authors.forename: Maria Lucia
authors.initials: ML
authors.lastname: Cascavilla
authors.forename: Carlo
authors.initials: C
authors.lastname: La Spina
authors.forename: Monica
authors.initials: M
authors.lastname: Varano
authors.forename: Francesco
authors.initials: F
authors.lastname: Bandello
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D020256:Choroidal Neovascularization / Q000175:diagnosis* / Q000188:drug therapy; D016903:Drug Monitoring; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000175:diagnosis* / Q000188:drug therapy; D009887:Ophthalmoscopy; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab