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AMD edemas: diagnosis, follow‐up, therapeutic, prognosis, spectral domain OCT, fluorescein, ICG angiographies interests
Author(s) -
GONZALEZ C
Publication year - 2010
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2010.288.x
Subject(s) - medicine , fluorescein angiography , ophthalmology , optical coherence tomography , edema , visual acuity , macular edema , epiretinal membrane , surgery , radiology , vitrectomy
Purpose To evaluate OCT, Fluorescein, ICG Angiography signs of various types edemas complicating AMD, so their diagnosis, follow‐up, therapeutic , prognosis value Methods 236 eyes of 203 patients, with retrofoveolar neovascularisation complicating AMD, were treated with a series of 3 IVT Ranibizumab protocol. First and 2 months’ interval follow‐up exam included ETDRS visual acuity (VA), complete ophthalmic examination, fluorescein(FA) and infracyanine (ICG) angiography, and Spectral Domain optical coherence tomography OCT ( Spectralis and Cirrus). Exudative and inflammatory reaction were analyzed cut to cut, cut by cut and time to time at OCT. Thickness, edema type, other lesions are always evaluated and compared. Results Diffuse edema was present in 90% eyes, focal diffuse in 25%, OMC in 60% cases , SRD in 30% , resorption vacuoles in 25% , inflammatory reaction in 95% cases, epiretinal membrane (ERM) was associated in 20% cases. During therapeutic protocol , diffuse edema was 70% reduced in 80%, OMC 75% in 65% cases, and SRD about 80% in 78% cases. OCT alone allow treatment decision in 74% cases, therapeutic protocol determination in 58% cases, prognosis and scalable potential pathology in 45% cases. FA, above all ICG were needed and necessary to determine neovascular activity. Conclusion Edemas are main signs of neovascular AMD. OCT is the reference exam for their evaluation. OCT efficiency and reliability depend on results’ analytic and comparative analysis. Confrontation of clinic, AF, ICG, OCT data enable diagnosis error coefficient to be down by 42% and prove anyone exam complement each other, particularly FA and ICG.OCT is of course necessary but not sufficient to well determine and evaluate AMD edemas.