title: Predictability of Recalcitrance in Neovascular Age-Related Macular Degeneration With Indocyanine Green Angiography.
abstract: OBJECTIVE
  This study aimed to evaluate the utility of indocyanine green (ICG) angiography in predicting recalcitrance in neovascular age-related macular degeneration (nAMD).
  
  
  METHODS
  A retrospective case series.
  
  
  METHODS
  The charts of treatment-naive subjects with nAMD undergoing anti-vascular endothelial growth factor (anti-VEGF) therapy during a 6-month period were retrospectively reviewed. The study group consisted of subjects with persistent retinal edema on optical coherence tomography (OCT) despite 6 consecutive monthly anti-VEGF injections. The control group was age-matched to the study group and consisted of subjects who demonstrated complete resolution of retinal edema on OCT after 3 or fewer monthly anti-VEGF injections.
  
  
  RESULTS
  There were 42 study cases and 42 controls included in the analysis. The baseline visual acuity, central macular thickness on OCT, and choroidal neovascularization (CNV) surface area on ICG angiography were statistically similar between the study and control groups. The CNV surface area on ICG angiography 2 months after starting consecutive monthly anti-VEGF injections increased from a baseline of 1.78 ± 0.86 to 2.66 ± 0.92 mm2 in the study group (P = 0.008) and decreased from a baseline of 1.94 ± 0.97 to 1.12 ± 0.05 mm2 in the control group (P = 0.04); this change in CNV size on ICG angiography from baseline to 2-month follow-up was statistically significant between the study and control groups (P < 0.0001).
  
  
  CONCLUSIONS
  Change in CNV surface area on ICG angiography can predict which subjects with nAMD are likely to have persistent retinal edema on OCT after 6 or more consecutive monthly anti-VEGF injections.
authors.affiliation: From the *Southwest Retina Specialists; †Panhandle Eye Group; and ‡Department of Surgery, Texas Tech University Health Science Center, Amarillo, TX.
authors.forename: Ryan B
authors.initials: RB
authors.lastname: Rush
authors.forename: Sloan W
authors.initials: SW
authors.lastname: Rush
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000627:therapeutic use; D016022:Case-Control Studies; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods*; D006801:Humans; D007208:Indocyanine Green / Q000008:administration & dosage*; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab / Q000627:therapeutic use; D040262:Receptors, Vascular Endothelial Growth Factor / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D011993:Recombinant Fusion Proteins; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; D000068258:Bevacizumab; D040262:Receptors, Vascular Endothelial Growth Factor; D007208:Indocyanine Green; D000069579:Ranibizumab