Abstract
OBJECTIVES: To define neovascularization (NV) patterns and their association with exudative activity in type 1 neovascular age-related macular degeneration (NVAMD). METHODS: In optical coherence tomography angiography (OCTA) images of type 1 NVAMD, we stratified NV patterns according to whether they contained core vessel (C+/C-) and fine branching vessels (F+/F-) or not into C - F +, C + F +, and C + F - groups. Qualitative analyses assessing the status of peripheral tiny branching, inner branching capillaries, arcade, loop, and perilesional halo and quantitative analyses considering the NV area, length, density, and numbers of junctions and endpoints (open-ended vessels) in NV were conducted according to NV patterns and the presence of exudation on structural OCT. RESULTS: Among 96 eyes, exudation was found in the C - F + (33.3%) and C + F + (47.6%) groups, related to peripheral tiny branching in both groups (p = 0.022 and p < 0.001) and perilesional halo in the C + F + group (p < 0.001). Peripheral arcades, inner branching capillaries, and loops were observed in more than half (68.3%, 58.7%, and 69.8%) in the C + F + group but not related with exudative activity in the C + F + group. In quantitative analysis, the number of endpoints was associated with exudation in univariate and multivariate analyses (p = 0.011 and p = 0.016) in C + F + group. CONCLUSIONS: After pattern classification, type 1 NV patterns with fine branching vessels were considered to have exudative activity compared to NV without fine branching. The quantitative analysis of type 1 NV according to patterns showed the presence of peripheral tiny branching vessels was associated with NV activity.