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Volume-rendering three-dimensional image analysis of macular neovascularization in age-related macular degeneration

Eye volume 38, pages 1125–1132 (2024)Cite this article

Subjects

Abstract

Background

To visualize and investigate the three-dimensional (3D) images of macular neovascularization (MNV) in eyes with neovascular age-related macular degeneration using optical coherence tomography angiography (OCTA) according to the treatment response to intravitreal aflibercept injection (IVI).

Methods

OCTA images at baseline and 12 weeks (after three loading IVIs) were retrospectively reconstructed as 3D images for patients with type 1 and 2 MNV treated with the “pro-re-nata” regimen. The fluid-free and persistent fluid groups were divided according to the presence of subretinal and intraretinal fluid at 12 weeks after treatment. Using reconstructed 3D images of MNV, the volume, average volume per slice, and z-axis of the volumetric structure were evaluated.

Results

Twenty-three and nine were classified into the fluid-free and persistent fluid groups, respectively. The MNV volume decreased significantly from baseline to 12 weeks in the fluid-free group (p = 0.005), not in the persistent fluid group (p = 0.250). The average volume of MNV per slice at 12 weeks correlated with the persistent fluid group in both the univariate and multivariate analyses (p = 0.034, p = 0.039, Exp [B] = 14.005).

Conclusions

This study may provide a perspective on vascular volumetric changes of MNV according to treatment response.

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Fig. 1: Volume-rendering process of the three-dimensional image of macular neovascularization (MNV) in age-related macular degeneration.
Fig. 2: Enface image of optical coherence tomography angiography (OCTA) and three-dimensional (3D) reconstructed macular neovascularization (MNV) image from the fluid-free group.
Fig. 3: Enface image of optical coherence tomography angiography (OCTA) and three-dimensional (3D) reconstructed macular neovascularization (MNV) image from the persistent fluid group.
Fig. 4: The macular neovascularization (MNV) area in enface image (mm2), MNV volume (mm3), volume per slice (mm3), and z-axis thickness in three-dimensional (3D) reconstructed MNV image at baseline and 12 weeks.

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Data availability

Image data extracted (MC) from the HEYEX software (Heidelberg Engineering, Heidelberg, Germany), and clinical information were anonymized by the first author (MC) and securely stored on an encrypted portable device. Raw data, including image data and clinical information, as well as supplementary video files (also anonymized), are available upon request to the first author or corresponding author (MC and SWK).

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Funding

This research was supported in part by the Bio & Medical Technology Development Program of the NRF funded in part by the Korean government, the Ministry of Science and ICT (MSIP) (NRF- 2020R1A2C1005729).

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Authors and Affiliations

  1. Department of Ophthalmology, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea

    Mihyun Choi, Seong-Woo Kim, Cheolmin Yun & Jaeryung Oh

  2. Department of Chemistry, University of Illinois Urbana-Champaign, Champaign, IL, USA

    Sangheon Han

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Contributions

MC and SWK were involved in the conception and design of the study. MC, SH were involved in the image extraction and data analysis. MC, SH and SWK were involved in data collection and literature research. SWK, CY and JO were involved in the interpretation and critical revision of the article. MC was involved in drafting of the manuscript. MC, SH, SWK, CY and JO were involved in the final approval of the article.

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Correspondence to Seong-Woo Kim.

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Choi, M., Han, S., Kim, SW. et al. Volume-rendering three-dimensional image analysis of macular neovascularization in age-related macular degeneration. Eye 38, 1125–1132 (2024). https://doi.org/10.1038/s41433-023-02838-9

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