title: SEMIAUTOMATED QUANTITATIVE APPROACH TO CHARACTERIZE TREATMENT RESPONSE IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION: A Real-World Study.
abstract: OBJECTIVE
  To perform a quantitative study of the vascular microstructure in actively treated choroidal neovascularization by optical coherence tomographic angiography.
  
  
  METHODS
  Patients undergoing individualized anti-vascular endothelial growth factor therapy of minimum 12 months duration were included in this cross-sectional observational study and imaged using optical coherence tomographic angiography. En face optical coherence tomographic angiography images were analyzed for quantitative features, such as junction density, vessel length, and lacunarity using validated software (Angiotool). Patients were divided into 2 groups depending on their individualized treatment interval: "good responders, treated less frequently than 6 weeks" versus "poor responders, treated every 6 weeks or more frequently." Nonparametric testing was used to assess differences between these groups.
  
  
  RESULTS
  Twenty-five eyes of 23 consecutive patients with a median 58-month history of choroidal neovascularization, treated by median of 34 anti-vascular endothelial growth factor injections, were included in the analysis. There was no significant difference between any of the microvascular choroidal neovascularization features between the 2 groups (P > 0.05).
  
  
  CONCLUSIONS
  The semiautomated vessel segmentation software provides an objective and quantitative approach for choroidal neovascularization characterization. The consistently nonsignificant outcomes between the groups may provide evidence to support the "normalization hypothesis." This would suggest that regardless of treatment interval, individualized therapy in these eyes established vessel stability.
authors.affiliation: *Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; and †Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
authors.forename: Philipp K
authors.initials: PK
authors.lastname: Roberts
authors.forename: Peter L
authors.initials: PL
authors.lastname: Nesper
authors.forename: Manjot K
authors.initials: MK
authors.lastname: Gill
authors.forename: Amani A
authors.initials: AA
authors.lastname: Fawzi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D003430:Cross-Sectional Studies; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods*; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D058449:Intravitreal Injections; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab / Q000008:administration & dosage*; D015203:Reproducibility of Results; D012171:Retinal Vessels / Q000473:pathology*; D012984:Software; D013997:Time Factors; D041623:Tomography, Optical Coherence / Q000379:methods*; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity; D057135:Wet Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D020533:Angiogenesis Inhibitors; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab