Research Article

Characterizing Flow and Structure of Diabetic Retinal Neovascularization after Intravitreal Anti-VEGF Using Optical Coherence Tomography Angiography: A Pilot Study

Table 1

Demographics and primary endpoints of changes of diabetic neovascularization measured with optical coherence tomography angiography (OCTA) after intravitreal anti-VEGF.

PatientAgeEyeNV#Previous treatmentInitial treatmentRetreatment/causeChange (%) of NV-structure size from baseline (=100%)Chang (%) of NV-angio size from baseline (=100)Flow density within structural area (FD-structure ) in %Flow density within angio area (FD-angio) in %Last follow-up in weeks from baseline (and from last anti-VEGF)Comments
NV-structure posttreatmentNV-structure last follow-upNV-angio posttreatmentNV-angio last follow-upFD-Structure baselineFD-structure posttreatmentFD-structure last follow-upFD-angio postbaselineFD-angio posttreatmentFD-angio last follow-upLast clinical follow-upLast OCTA imaging

A59Right1Treatment-naïve4 monthly IVTYes NV recurrance−51%−53%−76%−83%64%38%28%81%69%59%46 (0)46 (0)Recurrence of NV with vitreous bleeding at week 34 was observed. Rapid regression of NV after retreatment.

A59Left2Treatment-naïve4 monthly IVTYes NV recurrance−8%−3%−78%−85%62%25%16%62%66%75%45 (0)45 (0)Retreatment after 37 weeks due to recurrence of NV and vitreous bleeding of fellow eye.

B30Right3PRP, 3 months before baseline3 monthly IVTYes for DME−100%−100%−100%−100%61%0%0%62%0%0%50 (5)50 (5)Complete regression after initial treatment block. At weeks 27 and 44 anti-VEGF was administered for DME.

B30Left4PRP, 10 months before baseline3 monthly IVTNo+12%−27%−11%+13%81%42%40%89%51%53%51 (42)51 (42)
C48Right5Treatment-naïve3 monthly IVTNo+28%+196%−65%−20%82%52%49%71%58%54%65 (53)19 (9)Consistent regression of % flow in structure and % flow in flow area, inconsistent changes of structure and flow area. Stable and clinically inactive PDRP in clinical follow-up for one year after last treatment

C48Left6Treatment-naïve3 monthly IVTNo−15%−17%−24%−38%79%26%41%82%36%57%64 (53)23 (13)Regression of % flow in structure and % flow in flow area, and flow area with grossly unchanged structure area. Partial recurrence in OCTA over time without clinical signs of recurrence for one year after the last treatment.

D49Left7Treatment-naïve3 monthly IVTNo+16%−6%−32%−34%44%30%41%48%38%45%63 (45)44 (26)Regression of % flow in structure and % flow in flow area. Lesser regression of flow. Grossly unchanged structure area, Partial recurrence in OCTA over time without clinical signs of recurrence for 10 months after the last treatment.
Previously treated for DME with anti-VEGF.

E51Right8Treatment-naïve3 monthly IVTNo−23%+52%−33%−30%76%73%27%79%84%54%48 (38)48 (38)Delayed reduction of % flow in structure and flow area. Earlier, but inconsistent regression of structure and flow areas. Clinically stable for 9 months after last treatment.

E51Right9Treatment-naïve3 monthly IVTNo−27%+3%−48%−2%72%65%70%72%83%73%48 (38)29 (19)Initial reduction of % flow in structure area and regression of flow area, followed by inconsistent recurrence. Strong fluctuations of structure area and % flow area around the baseline value.

Summary table of all evaluated diabetic retinal neovascularizations (NV), baseline characteristics, and special observations. Measurements at baseline, posttreatment three months after the initial treatment block, and at the final OCTA measurements. Follow-up time for OCTA imaging and clinical follow-up are reported from baseline and from the last anti-VEGF injection. Continuous lines are separating patients, separated lines are separating eyes, and fine lines are separating NV within the same eye. DME = diabetic macular edema; IVT = intravitreal therapy with anti-VEGF (ranibizumab or aflibercept); OCTA = optical coherence tomography angiography; PRP = panretinal laser photocoagulation; RT = retreatment.