Analyzing relative blood flow speeds in choroidal neovascularization using variable interscan time analysis OCT angiography

Rebhun CB, Moult EM, Ploner S, Moreira-Neto C, Alibhai AY, Schottenhamml J, Lee B, Choi W, Rifai FA, Tams M, Husvogt L, Baumal CR, Witkin AJ, Maier A, Rosenfeld P, Duker JS, Fujimoto JG, Waheed NK (2018)

Publication Language: English

Publication Type: Journal article, Medical case study

Publication year: 2018

Journal

Ophthalmology Retina Elsevier

Book Volume: 2

Pages Range: 306-319

Journal Issue: 4

URI: https://www.sciencedirect.com/science/article/abs/pii/S2468653017303561?via=ihub

DOI: 10.1016/j.oret.2017.08.013

Abstract

Purpose

Longitudinally visualizing relative blood flow speeds within choroidal neovascularization (CNV) may provide valuable information regarding the evolution of CNV and the response to vascular endothelial growth factor (VEGF) inhibitors.

Design

Retrospective, longitudinal case series conducted at the New England Eye Center.

Participants

Patients with either treatment-naïve or previously treated CNV secondary to neovascular age-related macular degeneration.

Methods

Optical coherence tomography angiography (OCTA) was performed using a 400-kHz, 1050-nm swept-source OCT system with a 5-repeat B-scan protocol. Variable interscan time analysis (VISTA) was used to compute relative flow speeds from pairs of B-scans having 1.5- and 3.0-ms separations; VISTA signals then were mapped to a color space for display.

Main Outcome Measures

Quantitative outcomes included OCTA-based area and volume measurements of CNV at initial and follow-up visits. Qualitative outcomes included VISTA OCTA analysis of relative blood flow speeds, along with analysis of contraction, expansion, densification, and rarefication of CNV.

Results

Seven eyes of 6 patients (4 women and 2 men) with neovascular age-related macular degeneration were evaluated. Two eyes were treatment naïve at the initial visit. Choroidal neovascularization in all eyes at each visit showed relatively higher flow speeds in the trunk, central, and larger vessels and lower flow speed in the small vessels, which generally were located at the periphery of the CNV complex. Overall, the CNV appeared to expand over time despite retention of good visual acuity in all patients. In the treatment-naïve patients, slower-flow-speed vessels contracted with treatment, whereas the larger vessels with higher flow speed remained constant.

Conclusions

Variable interscan time analysis OCTA allows for longitudinal observations of relative blood flow speeds in CNV treated with anti-VEGF intravitreal injections. A common finding in this study is that the main trunk and larger vessels seem to have relatively faster blood flow speeds compared with the lesions' peripheral vasculature. Moreover, an overall growth of chronically treated CNV was seen despite retention of good visual acuity. The VISTA framework may prove useful for developing clinical end points, as well as for studying hemodynamics, disease pathogenesis, and treatment response.

Authors with CRIS profile

Stefan Ploner Lehrstuhl für Informatik 5 (Mustererkennung) Julia Schottenhamml Lehrstuhl für Informatik 5 (Mustererkennung) Lennart Husvogt Lehrstuhl für Informatik 5 (Mustererkennung) Andreas Maier Lehrstuhl für Informatik 5 (Mustererkennung)

Involved external institutions

Massachusetts Institute of Technology (MIT) US United States (USA) (US) University of Miami US United States (USA) (US) Tufts Medical Center US United States (USA) (US) University of South Alabama US United States (USA) (US) Tufts University US United States (USA) (US)

How to cite

APA:

Rebhun, C.B., Moult, E.M., Ploner, S., Moreira-Neto, C., Alibhai, A.Y., Schottenhamml, J.,... Waheed, N.K. (2018). Analyzing relative blood flow speeds in choroidal neovascularization using variable interscan time analysis OCT angiography. Ophthalmology Retina, 2(4), 306-319. https://dx.doi.org/10.1016/j.oret.2017.08.013

MLA:

Rebhun, Carl B., et al. "Analyzing relative blood flow speeds in choroidal neovascularization using variable interscan time analysis OCT angiography." Ophthalmology Retina 2.4 (2018): 306-319.

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