OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY AS A RELIABLE PROGNOSTIC TOOL FOR ACTIVE NEOVASCULARIZATION OF THE DISK TREATED WITH PANRETINAL PHOTOCOAGULATION AND/OR RANIBIZUMAB

Purpose: To compare the prognosis of neovascularization of the disk (NVD) after panretinal photocoagulation and/or ranibizumab treatment, based on optical coherence tomography angiography patterns. Methods: In this prospective study, treatment-naive patients with stage IV diabetic retinopathy and NVD were imaged with 6 × 6 mm 2 optical coherence tomography angiography scans. Neovascularization of the disk was classified according to optical coherence tomography angiography morphologic features: different sources (retinal arteries and veins), different activities (exuberant vascular proliferation+ and exuberant vascular proliferation−), and different configurations (Type I and II, III and IV). All patients were treated with panretinal photocoagulation or in combination with ranibizumab. Patients were monitored monthly to detect the occurrence of vitreous hemorrhage and/or retinal detachment, as well as changes in best-corrected visual acuity and NVD. Results: Among 114 eyes, 35 developed vitreous hemorrhage and/or retinal detachment (mean onset 6.1 months). Different configurations and exuberant vascular proliferation status (±) significantly affected vitreous hemorrhage and/or retinal detachment occurrence ( P < 0.05). Neovascularization of the disk regression occurred in 52 eyes, with exuberant vascular proliferation status significantly influencing resolution ( P = 0.022). No significant effect was observed on visual acuity ( P > 0.05). Conclusion: Neovascularization of the disk can be classified into different patterns based on morphologic features in optical coherence tomography angiography, which play a crucial role in the prognosis of NVD patients after panretinal photocoagulation and/or ranibizumab treatment.