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Neovascular amd: multimodal criteria of neovascular activity
Author(s) -
GONZALEZ C
Publication year - 2014
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2014.f073.x
Subject(s) - medicine , choroidal neovascularization , neovascularization , ophthalmology , fluorescein angiography , fundus (uterus) , macular edema , grading (engineering) , visual acuity , surgery , angiogenesis , civil engineering , engineering
Purpose To evaluate the multimodal criteria and the best evaluation of neovascular activity to indicate recurrence and so treatment indication Methods 218 eyes of 170 patients, 50 men, 120 women, with subretinal neovascularization complicating AMD. First and 2 months’ interval follow‐up exam included ETDRS visual acuity (VA), complete ophthalmic examination with fundus exam, optical coherence tomography (HRA spectral domain OCT), fluorescein (FA) and infracyanine (ICG) angiography. VA and OCT were done before each IVT Results Each exam was analyzed, evaluation was given, and compared to previous one. A score was established for each data, so exam, using cross. Every score was added to each other, the value of final score determine the degree of activity. The cross grading scale was: for VA: impaired = ++, same = +, improved = 0; for OCT: increased (inflammation, diffuse edema, MCO, SRD, Neovascularization thickness) = ++, same = +, reduced = 0; for FA: increased (diffusion, occults, PED, MCO, Neovascularization density) = ++ (according to increased intensity : ++++ (intense), +++ (moderate), ++ (mild)), same = +, decreased = 0; for ICG: High Flow NeoVx = ++++, Middle Flow NeoVx = +++, Low Flow NeoVx = ++. Score superior or equal to 8 mean Neovascular activity and so treatment indication. Using those criteria, Neovascular activity definition is more discriminating and efficient. Treatment indications are more precise and discerning. With those Neovascular activity and indication treatment criteria, this so called Proreactive protocol was defined and applied Conclusion The multimodal criteria of Neovascular activity allow us to improve Neovascularization definition, then treatment indications, therefore to propose Proreactive protocol treatment ,optimization of antiVEGF IVT treatment