Reduction of retinal vessel density in non-exudative macular neovascularization: a retrospective study

Yang Gao; Su Zhang; Yue Zhao; Tingting Yang; Paulo Moreira; Guangli Sun

doi:10.3389/fmed.2023.1219423

Reduction of retinal vessel density in non-exudative macular neovascularization: a retrospective study

Front Med (Lausanne). 2024 Jan 4:10:1219423. doi: 10.3389/fmed.2023.1219423. eCollection 2023.

Authors

Yang Gao¹, Su Zhang², Yue Zhao², Tingting Yang², Paulo Moreira^{3

4}, Guangli Sun²

Affiliations

¹ Department of Ophthalmology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong Province, China.
² The Affiliated Eye Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China.
³ International Healthcare Management Research and Development Center (IHM-RDC), Shandong Provincial Qianfoshan Hospital, Jinan, Shandong Province, China.
⁴ Atlantica Instituto Universitario, Gestao em Saude, Oeiras, Portugal.

Abstract

Purpose: The purpose of this study is to identify predictive activation biomarkers in retinal microvascular characteristics of non-exudative macular neovascularization (MNV) and avoid delayed treatment or overtreatment of subclinical MNV. The main objective is to contribute to the international debate on a new understanding of the role of retinal vessel features in the pathogenesis and progression of non-exudative MNV and age-related macular degeneration (AMD). A discussion on revising-related clinical protocols is presented.

Methods: In this retrospective study, the authors included eyes with non-exudative MNV, eyes with exudative AMD, and normal eyes of age-matched healthy subjects. The parameters were obtained by optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA).

Results: In total, 21 eyes with exudative AMD, 21 eyes with non-exudative MNV, and 20 eyes of 20 age-matched healthy subjects without retinal pathology were included. Vessel density (VD) of the deep vascular complex (DVC) in eyes with non-exudative MNV was significantly greater than that in eyes with exudative AMD (p = 0.002), while for superficial vascular plexus (SVP) metrics, no VD differences among sectors were observed between eyes with non-exudative MNV and eyes with exudative AMD.

Conclusion: The reduction in retinal vessel density, especially in the DVC, seems to be involved in or be accompanied by non-exudative MNV activation and should be closely monitored during follow-up visits in order to ensure prompt anti-angiogenic therapy. A discussion on applicable clinical protocols is presented aiming to contribute to new insights into ophthalmology service development which is directed to this specific type of patient and diagnosis.

Keywords: age-related macular degeneration; non-exudative macular neovascularization; optical coherence tomography; retinal blood flow; retinal image.