Evaluation of neovascular age-related macular degeneration using optical coherence tomography angiography

The aim of this study was to compare the qualitative and quantitative characteristics of treatment-naïve eyes with neovascular age-related macular degeneration (nAMD) and healthy controls using optical coherence tomography angiography (OCTA). In this context, OCTA data from 90 patients with nAMD and 90 healthy individuals with no statistically significant difference in mean age or sex distribution were analyzed. Clinical and demographic data of the patient group, as well as optical coherence tomography (OCT) findings and OCTA images of both groups, were evaluated. In the qualitative analysis, macular neovascularizations (MNV) were classified according to two previously defined classification systems. In the quantitative analysis, in addition to vessel density measurements, vessel length density, mean vessel diameter, and junction density parameters were analyzed using the Optical Coherence Tomography Angiography Vascular Analyzer (OCTAVA) software. In the nAMD group, vessel density in the superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC) layers was significantly lower than in the control group, while the outer retina (OR) layer showed higher density values. Similarly, vessel length density, mean vessel diameter, and branching point density parameters were lower in the SCP and DCP layers of the nAMD group. These findings indicate that the retinal and choroidal vascular structures in nAMD patients exhibit marked structural and quantitative differences compared to healthy individuals. In conclusion, quantitative parameters obtained by OCTA provide an objective assessment of retinal vascularization. Novel metrics derived from supplementary software analyses may serve as potential biomarkers for monitoring disease progression in nAMD.