title: Identification and clinical role of choroidal neovascularization characteristics based on optical coherence tomography angiography.
abstract: OBJECTIVE
  To suggest a novel classification of neovascular age-related macular degeneration (AMD) based on optical coherence tomography angiography (OCTA) and to correlate morphological characteristics based on optical coherence tomography (OCT)/OCTA with clinical criteria of disease activity.
  
  
  METHODS
  A total of 88 eyes with neovascular AMD (14 treatment-naïve, 74 eyes following anti-vascular endothelial growth factor treatment (VEGF)) were examined using the AngioVue OCTA system (Optovue, Inc., Fremont, CA, USA) and evaluated based on vascular morphology. Choroidal neovascularization (CNV)-vessel morphology based on OCTA and associations with retinal layers were described and correlated with clinical markers of disease activity.
  
  
  RESULTS
  In treatment-naïve CNV, CNV-vessel morphology based on OCTA showed a dense-net configuration (DN) in 12 of 14 eyes, a loose-net configuration (LN) in one of 14 eyes and an unidentifiable CNV pattern in one of 14 eyes, whereas in treated CNV, DN was registered in 43.2% (32/74), LN in 27% (20/74), DN with additional LN (mixed type) in 14.9% (11/74) and an unidentifiable CNV pattern in 14.9% (11/74). Clinical correlations revealed a significantly longer disease duration for LN with a median value of 4.3 years compared to DN with 2.0 years (p = 0.009) and for CNV involving the outer retina with 3.1 years compared to CNV not involving the outer retina with 1.9 years (p = 0.051).
  
  
  CONCLUSIONS
  Optical coherence tomography angiography (OCTA) allows identification of distinct CNV-specific vascular patterns at the level of the outer retinal layer and choriocapillaris. Correlation with clinical and functional parameters may be useful to better understand pathophysiological mechanisms and guide efficient therapeutic strategies.
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
authors.forename: Florian
authors.initials: F
authors.lastname: Sulzbacher
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Pollreisz
authors.affiliation: Center for Medical Statistics, Informatics, and Intelligent Systems, Section for Clinical Biometrics, Medical University of Vienna, Vienna, Austria.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kaider
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Kickinger
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Sacu
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
authors.forename: Ursula
authors.initials: U
authors.lastname: Schmidt-Erfurth
mesh_terms: D000369:Aged, 80 and over; D002829:Choroid / Q000473:pathology*; D020256:Choroidal Neovascularization / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods*; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity
keywords: age related macular degeneration; angiogenesis; optical coherence tomography; optical coherence tomography angiography