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IMPORTANCE: CD11b+ immune cells have been implicated in the formation of choroidal neovascularization in experimental studies on animals and disease-association studies on humans. However, the clinical importance of such observations remains unknown. OBJECTIVE: To investigate whether the proportion of CD11b+ circulating monocytes is associated with the number of anti–vascular endothelial growth factor (anti-VEGF) injections in neovascular age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV). DESIGN, SETTING, AND PARTICIPANTS: These observational cohort studies collected data from January 1, 2010, through December 31, 2013, and from January 1, 2015, through December 31, 2018. Fresh venous blood samples were acquired for flow cytometric immune studies in patients with neovascular AMD or PCV receiving treatment with aflibercept or ranibizumab as needed for 36 months. Patients (n = 81) without immune diseases were consecutively recruited from a single center in Denmark. EXPOSURES: Proportion of CD11b+ circulating monocytes. MAIN OUTCOMES AND MEASURES: The estimation of the number of intravitreal anti-VEGF injections given at 12, 24, and 36 months by the proportion of CD11b+ circulating monocytes and the correlation between these values. The angiogenic role of CD11b+ circulating monocytes was further evaluated by investigating the expression of the known proangiogenic receptor CCR2. RESULTS: Eighty-one patients were included in the analysis (54% women; mean [SD] age, 76 [7] years). The proportion of CD11b+ monocytes at baseline positively estimated the future number of anti-VEGF injections at 12 (ρ = 0.77; 95% CI, 0.35-0.93; P = .004), 24 (ρ = 0.82; 95% CI, 0.44-0.95; P = .002), and 36 (ρ = 0.78; 95% CI, 0.34-0.94; P = .005) months. This association was also found retrospectively in a larger sample of patients with neovascular AMD at 12 (ρ = 0.46; 95% CI, 0.16-0.68; P = .004), 24 (ρ = 0.49; 95% CI, 0.20-0.70; P = .002), and 36 (ρ = 0.65; 95% CI, 0.41-0.80; P < .001) months and patients with PCV at 12 (ρ = 0.27; 95% CI, –0.28 to 0.68; P = .30), 24 (ρ = 0.60; 95% CI, 0.12-0.85; P = .02), and 36 (ρ = 0.70; 95% CI, 0.27-0.90; P = .005) months, suggesting that this association is not specific to AMD but rather reflects VEGF activity in neovascularization. CD11b+ monocytes highly coexpressed CCR2, an important monocytic marker of proangiogenic activity. CONCLUSIONS AND RELEVANCE: Results of this study demonstrated that the proportion of circulating CD11b+ monocytes estimated and correlated with the number of anti-VEGF injections in patients with neovascular AMD and PCV. Additional longitudinal studies are needed to determine whether these findings have clinical relevance to influence treatment algorithms or provide novel targets for medical therapy.

Purpose. To describe optical coherence tomography (OCT) angiography (OCTA) in a case of Purtscher retinopathy. Methods. A 16-year-old male underwent ophthalmological examination including color fundus photography, spectral domain OCT, OCTA, and microperimetry. Examination was performed 10 days, 1 month, and 6 months after the trauma. Diagnosis was based on the characteristic clinical presentation. Patients. A single patient case. Results. Only the right eye was affected, and all examinations of the left eye were normal. The visual acuity of the right eye was 0.03 (Snellen equivalent) at 10 days and at one month, improving to 0.16 at 6 months. The imaging confirmed the findings of Purtscher retinopathy with ischemic whitening of the retina and retinal hemorrhages and thickened inner retina on OCT. Microperimetry showed reduced sensitivity in the central macula of the right eye. OCTA revealed nonperfusion in both the superficial and the deep retinal capillary plexus of the right eye. Conclusion. The OCTA in traumatic Purtscher retinopathy following traffic accident showed nonperfusion in both the superficial and the deep capillary plexus of the retina. OCTA is a valuable noninvasive diagnostic examination in Purtscher retinopathy, and fluorescein angiography became redundant in this case.