Optical Coherence Tomography Angiography Evaluation of Morphological andVascular Changes in Choroidal Neovascularization in Response to Anti-Angiogenic Treatment

Objective: To detect qualitative and quantitative analysis of the choroidal neovascular membrane based on opticalcoherence tomography angiography OCTA in response to treatment with anti-angiogenesis. Patients and methods: This is a prospective observational study recruited 20 eyes of 20 patients with treatment-naiveCNVM. Patients were examined using the OCTA before and after treatment with Ranibizumab. Patients werefollowed-up monthly over 3 successive months and 1 month after the last injection. The collected data werestatistically analyzed using SPSS software version 22. Repeated measures ANOVA was performed and a paired t-testwas also used for comparison. Main outcome measures: membrane types, patterns, corrected visual acuity, retinalfluids, membrane size, and flow area; all were measured pre and post-intervention. Results: Five patients were males and 15 were females (50.6 ± 17.7 years). Different configuration were detected; adensenet configuration in 6 eyes, a loosenet configuration in 6 eyes, mixed net in 3 eyes, and an unidentifiablepattern in 5 eyes. Visual acuity improved post-injection in all membrane patterns (p value 0.002 in loose-net andunidentifiable types). Signs of membrane activity, size, and flow area; all decreased in all patterns following treatment(p value 0.001). Conclusions: OCTA in conjunction with OCT is both needed for more precise evaluation of differentmorphological and functional membrane criteria at which treatment strategy is based. Detection of blood flowchanges within the membrane itself can be considered as reliable biomarkers in monitoring the membrane activity.