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Abstract
During the past 15 years, new treatment paradigms for neovascular age-related macular degeneration (nvAMD) have evolved due to the advent of intravitreal anti-vascular endothelial growth factor (VEGF) therapy and rapid advances in retinal imaging. Recent publications describe eyes with type 1 macular neovascularization (MNV) as showing more resistance to macular atrophy than eyes with other lesion types. We sought to explore whether the perfusion status of the native choriocapillaris (CC) surrounding type 1 MNV influences its pattern of growth. To evaluate this effect, we analyzed a case series of 22 eyes from 19 nvAMD patients with type 1 MNV exhibiting growth on swept-source optical coherence tomography angiography (SS-OCTA) over a minimum follow-up of 12 months. We observed an overall weak correlation between type 1 MNV growth and CC flow deficits (FDs) average size (τ = 0.17, 95% CI [− 0.20, 0.62]) and a moderate correlation with CC FD % (τ = 0.21, 95% CI [− 0.16, 0.68]). Type 1 MNV was located beneath the fovea in most of the eyes (86%) and median visual acuity was 20/35 Snellen equivalent. Our results support that type 1 MNV recapitulates areas of CC blood flow impairment while serving to preserve foveal function.
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1 Vitreous Retina Macula Consultants of New York, New York, USA (GRID:grid.497655.c); iNOVA4Health, NOVA Medical School I Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisbon, Portugal (GRID:grid.10772.33) (ISNI:0000000121511713); NYU Grossman School of Medicine, Department of Ophthalmology, New York, USA (GRID:grid.137628.9) (ISNI:0000 0004 1936 8753)
2 iNOVA4Health, NOVA Medical School I Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisbon, Portugal (GRID:grid.10772.33) (ISNI:0000000121511713)
3 University of Washington, Department of Bioengineering, Seattle, USA (GRID:grid.34477.33) (ISNI:0000000122986657)
4 Vitreous Retina Macula Consultants of New York, New York, USA (GRID:grid.497655.c); NYU Grossman School of Medicine, Department of Ophthalmology, New York, USA (GRID:grid.137628.9) (ISNI:0000 0004 1936 8753)
5 University of Washington, Department of Bioengineering, Seattle, USA (GRID:grid.34477.33) (ISNI:0000000122986657); University of Washington, Department of Ophthalmology, Seattle, USA (GRID:grid.34477.33) (ISNI:0000000122986657)