title: Optical Coherence Tomography Angiography of Type 1 Neovascularization in Age-Related Macular Degeneration.
abstract: OBJECTIVE
  To analyze type 1 neovascular membranes in age-related macular degeneration (AMD) using optical coherence tomography (OCT) angiography, to correlate morphologic characteristics with imaging and clinical criteria, and to analyze structural features of type 1 neovascularization sequentially after anti-vascular endothelial growth factor (VEGF) therapy.
  
  
  METHODS
  Prospective interventional case series.
  
  
  METHODS
  Macular OCT angiography images were acquired using the RTVue XR Avanti with AngioVue. Distinct morphologic patterns and quantifiable features of the neovascular membranes were studied on en face projection images at baseline and follow-up.
  
  
  RESULTS
  Thirty-three eyes of 25 patients were included. In 75% of the eyes, a highly organized vascular complex could be identified. A large main central vessel trunk/feeder vessel could be seen in 72% of these eyes, with vessels radiating in a branching pattern either in all directions from the center of the lesion ("medusa" pattern), or from one side of the lesion ("seafan" pattern). Of the 18 eyes with follow-up OCT angiography, the lesion area and vessel density remained unchanged, even after anti-vascular endothelial growth factor (VEGF) therapy, indicating a more mature longstanding neovascular complex resistant to anti-VEGF therapy.
  
  
  CONCLUSIONS
  OCT angiography provides a unique opportunity to study the morphology of occult type 1 neovascular membranes in AMD and allows precise structural and vascular assessment noninvasively. We identified a large mature neovascular complex in approximately 75% of eyes, typically consisting of a feeder vessel and large branching vessels resistant to anti-VEGF therapy. OCT angiography may better guide evaluation and treatment of neovascular AMD, and may contribute to the development of improved therapies.
authors.affiliation: Doheny Eye Institute, Los Angeles, California; Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Laura
authors.initials: L
authors.lastname: Kuehlewein
authors.affiliation: Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California; Stein Eye Institute, Los Angeles, California.
authors.forename: Mayank
authors.initials: M
authors.lastname: Bansal
authors.affiliation: Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California; Stein Eye Institute, Los Angeles, California.
authors.forename: Tamara L
authors.initials: TL
authors.lastname: Lenis
authors.affiliation: Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California; Stein Eye Institute, Los Angeles, California.
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Iafe
authors.affiliation: Doheny Eye Institute, Los Angeles, California; Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: SriniVas R
authors.initials: SR
authors.lastname: Sadda
authors.affiliation: New England Eye Center and Tufts Medical Center, Tufts University, Boston, Massachusetts; CAPES Foundation, Ministry of Education of Brazil, Brasilia, Brazil.
authors.forename: Marco A
authors.initials: MA
authors.lastname: Bonini Filho
authors.affiliation: New England Eye Center and Tufts Medical Center, Tufts University, Boston, Massachusetts; Department of Electrical Engineering and Computer Science, and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, Massachusetts.
authors.forename: Talisa E
authors.initials: TE
authors.lastname: De Carlo
authors.affiliation: New England Eye Center and Tufts Medical Center, Tufts University, Boston, Massachusetts.
authors.forename: Nadia K
authors.initials: NK
authors.lastname: Waheed
authors.affiliation: New England Eye Center and Tufts Medical Center, Tufts University, Boston, Massachusetts.
authors.forename: Jay S
authors.initials: JS
authors.lastname: Duker
authors.affiliation: Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California; Stein Eye Institute, Los Angeles, California; Greater Los Angeles VA Healthcare Center, Los Angeles, California. Electronic address: dsarraf@ucla.edu.
authors.forename: David
authors.initials: D
authors.lastname: Sarraf
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000069579:Ranibizumab / Q000627:therapeutic use; D040262:Receptors, Vascular Endothelial Growth Factor / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D012163:Retinal Detachment / Q000473:pathology; D015861:Retinal Neovascularization / Q000175:diagnosis* / Q000188:drug therapy; D055213:Retinal Pigment Epithelium / Q000473:pathology; D058471:Subretinal Fluid; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity / Q000502:physiology; D057135:Wet Macular Degeneration / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D020533:Angiogenesis Inhibitors; D011993:Recombinant Fusion Proteins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab