Advanced Optical Coherence Tomography Angiography Analysis of Age-related Macular Degeneration Complicated by Onset of Unilateral Choroidal Neovascularization

Purpose: To analyze optical coherence tomography angiography (OCTA) quantitative features in patients affected by new-onset choroidal neovascularization (CNV) in 1 eye and early/intermediate age-related macular degeneration (AMD) in the fellow eye. Design: Case-control study. Methods: SETTING: Clinical practice. STUDY POPULATION: Thirty patients and 30 age-matched controls. OBSERVATION PROCEDURES: Both cohorts underwent complete ophthalmologic examination, including best-corrected visual acuity (BCVA) measurement, biomicroscopy, fluorescein angiography (FA) and indocyanine green angiography (ICGA) examination, optical coherence tomography, and OCTA scans. The 1-way a test with Bonferroni correction was used to assess statistical significance and Tau Kendall's correlation analysis was performed. MAIN OUTCOME MEASURES: BCVA, choroidal thickness, vessel density, vessel tortuosity, vessel dispersion. and vessel rarefaction. Results: Mean BCVA was 20/32 for CNV eyes and 20/20 for both fellow and control eyes. Choroidal thickness was 190.33 ± 63.98 μm for CNV eyes, 216.83 ± 50.31 μm for fellow eyes, and 310.52 ± 27.13 μm for controls. The quantitative analysis of retinal vessels revealed significant alterations, especially in the deep capillary plexus and radial peripapillary capillaries, both in CNV and in fellow eyes, compared with controls. In particular, decreased vessel density and tortuosity and increased dispersion and rarefaction were found. Several significant correlations were also found among the quantitative parameters adopted. Conclusions: New postprocessing OCTA parameters are able to detect deep retinal vascular alterations quantitatively, in both CNV-affected and fellow eyes of patients with new-onset CNV. Further investigations are warranted in order to explore the validity of these new approaches on follow-up.