Optical Coherence Tomography in Neovascular Age-Related Macular Degeneration
Pp. 161-169 (9)
Age-related macular degeneration (AMD) is the leading cause of blindness in the developed world.
With the advent of anti-VEGF therapy only a small proportion of patients with neovascular AMD will develop
severe visual impairment. Although, monthly injections of anti-VEGF treatment may have the potential to
achieve excellent visual outcomes, this regime is costly and not without risk. Hence, most retinal specialists opt to
use optical coherent topography (OCT) to guide patient’s re-treatment. OCT is also being used as a screening
tool to detect early signs of neovascular AMD in patients with age-related maculopathy as well as to help in
characterizing AMD phenotypes. Thus, OCT can be used to help in the differentiation between pure serous
retinal pigment epithelial detachment (PED) and vascularized PED. In the latter, subretinal fluid (SRF) is present
and can be identified by OCT; vascularized PED is amenable to anti-VEGF treatment. OCT may also be helpful
in the identification of retinal angiomatous proliferation (RAP) and polypoidal choriovasculopathy (PCV), two
forms of neovascular AMD which often require more intensive treatment.
Macula, maculopathy, retina, diabetes, fluorescein angiography, FFA, autofluorescence, AF, optical
coherence tomography, OCT, time domain, spectral domain, spectralis, stratus, age-related macular degeneration,
AMD, neovascular, atrophic, drusen, choroidal neovascular membrane, CNV, retinal angiomatous proliferation,
RAP, geographic atrophy, GA, subretinal fluid, intraretinal fluid, choroidal neovascular membrane, CNV, choroidal
neovascularisation, vascular endothelial growth factor, VEGF, anti-VEGF, occult, classic, pigment epithelial
detachment, PED, retinal pigment epithelial tear, retinal pigment epithelium, RPE, idiopathic polypoidal choroidal
vasculopathy, IPCV, disciform scar.
Oxford Eye Hospital, John Radcliffe Hospital, University of Oxford, Oxford, Oxford OX3 9DU, United Kingdom