PREDICTORS OF RECURRENT EXUDATION IN CHOROIDAL NEOVASCULARIZATION IN AGE-RELATED MACULAR DEGENERATION DURING A TREATMENT-FREE PERIOD

Purpose: To investigate predictors of recurrent exudation in choroidal neovascularization (CNV) of age-related macular degeneration on optical coherence tomography angiography (OCTA) images during an anti-vascular endothelium growth factor therapy-free period. Methods: Optical coherence tomography angiography images of 41 eyes of 41 patients with more than a 3-year history of anti-vascular endothelial growth factor therapy for neovascular age-related macular degeneration at the study baseline were evaluated retrospectively. The patients thereafter had a treatment-free period exceeding 6 months under an as-needed regimen and could be followed for an additional 6 months. Results: The square root of the CNV area in 19 eyes with recurrence during the second 6-month period enlarged significantly (P = 0.036) from 2.31 +/- 0.81 (mean +/- SD) to 2.86 +/- 0.87 mm during the treatment-free period but not in the 22 eyes without a recurrence. The percentages of branching with tiny vessels (42%) and peripheral arcades at the CNV termini (42%) were significantly (P < 0.001, respectively) higher in the recurrence group compared with the group in which the CNV was no longer active (14% and 5%, respectively). Conclusion: Choroidal neovascularization enlargement and features may guide treatment timing in eyes with exudative-free periods.