OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY ANALYSIS OF COHORT WITH PERIPAPILLARY CHOROIDAL NEOVASCULARIZATION.

PURPOSE: Although many studies have analyzed macular choroidal neovascularization (CNV) using optical coherence tomography angiography, few have focused on peripapillary CNV, which comprises approximately 10% of CNV cases. This study examines optical coherence tomography angiography vessel changes in patients with treated and untreated peripapillary CNV to better understand disease progression.

METHODS

Nineteen eyes with peripapillary CNV secondary to neovascular age-related macular degeneration were retrospectively analyzed. Treated eyes (n = 13) received anti-VEGF injections after a modified pro re nata regimen, whereas untreated eyes (n = 6) without macular involvement were closely observed. Median follow-up was 11.9 months (treated) and 8 months (untreated). High-quality optical coherence tomography angiography scans centered on the CNV lesions were selected and analyzed using validated software (ImageJ and AngioTool).

RESULTS

Treated eyes showed significant reductions in CNV lesion size, vessel density, and lacunarity after anti-VEGF therapy (ImageJ: P < 0.001; AngioTool: P = 0.0004). Untreated eyes exhibited significant lesion enlargement (ImageJ: P = 0.0356; AngioTool: P = 0.0013). None of the patients in the untreated group developed macular exudation during the study.

CONCLUSION

Peripapillary CNV without macular involvement may be considered for short-term observation in selected cases, as these lesions appeared indolent and stable over the limited follow-up period in our cohort. The vessels in optical coherence tomography angiography in the treated group showed regression in size after anti-VEGF therapy. These findings will potentially help clinicians better understand this entity.