Optical Coherence Tomography Angiography of Time Course of Choroidal Neovascularization in Response to Anti-Angiogenic Treatment

In Brief Purpose: To use optical coherence tomography (OCT) angiography to monitor the short-term blood flow changes in choroidal neovascularization (CNV) in response to treatment. Methods: In this retrospective report, a case of exudative CNV was followed closely with OCT angiography over three cycles of antiangiogenic treatment. Outer retinal flow index, CNV flow area and central macular retinal thickness were measured. Results: Quantitative measurements of CNV flow area and flow index showed rapid shutdown of flow over the initial 2 weeks, followed by reappearance of CNV channel by the fourth week, preceding fluid reaccumulation at 6 weeks. Conclusion: Frequent OCT angiography reveals a previously unknown pattern of rapid shutdown and reappearance of CNV channels within treatment cycles. OCT angiographic changes precede fluid reaccumulation and could be useful as leading indicators of CNV activity that could guide treatment timing. Further studies using OCT angiography in short intervals between antiangiogenic treatments are needed. This is the first known short-interval dynamic analysis of choroidal neovascularization (CNV) treatment response using Optical coherence tomography (OCT) angiography. OCT angiography parameters provide leading indicators of CNV activity that may be useful in guiding treatment.