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CNV size was measured using a free image analysis software ImageJ, open-source imaging processing software, 2. Twenty-five eyes of 25 patients were enrolled in our study mean age Paradigms concerning age-related macular degeneration have been shifting rapidly over the last decade, due to both therapeutic advances i. OCTA is a new retinal imaging technique providing information on the actual location of the choroidal neovascularization, on various abnormalities of the retinal and choroidal microvasculature in a noninvasive manner [ 1 β 3 ].
Its exponential growth over the last few years asserts for its usefulness not only in an academic setting giving insights into the pathogenesis of several macular disease , but also in a clinical setting [ 4 β 6 ]. Nevertheless, SD-OCT is a key element in detecting recurrences, and treatment decisions are frequently based solely on this noninvasive imaging method [ 7 β 9 ].
Classically, recurrences of CNV are defined on SD-OCT by a myriad of signs, ranging from subretinal or intraretinal fluid, subretinal hyperreflective material, or changes in the pigment epithelial detachment's height [ 7 β 11 ]. When comparing these signs to fluorescein angiography where the presence of late leakage or dye pooling is the central element in defining the presence of CNV [ 12 , 13 ] or indocyanine green angiography which allows a clear visualization in its late frames of occult CNV [ 14 ], the consequent conclusion is that of a growing complexity and greater refinement of the diagnosis provided by retinal imagery over time.
However, while the signs provided by SD-OCT or conventional angiography are used to define activity of CNV to this day in a clinical setting, the concept of CNV activity itself involves more complicated, intricate mechanisms than previously thought [ 15 ]. Moreover, recent fundamental research studies have concluded that, in addition to elevated VEGF levels, dysregulated inflammation and autoimmunity play an essential role in CNV pathogenesis [ 16 , 17 ].