Combined Fluorescein Angiography and Spectral-Domain Optical Coherence Tomography Imaging of Classic Choroidal Neovascularization Secondary to Age-Related Macular Degeneration Before and After Intravitreal Ranibizumab Injections

Coscas, Florence; Querques, Giuseppe; Forte, Raimondo; Terrada, C.; Coscas, G.; Souied, Eric H.

doi:10.1097/iae.0b013e318240a529

Cited by 18 publications

(9 citation statements)

References 23 publications

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“…Most eyes with type 2 CNV present a small ‘discrete’ PED associated with the highly reflective subretinal lesions (mainly located beneath the subretinal lesion). Increased thickness of the retina, SRF, cystoid spaces and PED are commonly observed 46. RAP (also called type 3 CNV) is described as small erosion or elevated RPE, a flap sign, or, later, a focal funnel-shaped defect in the RPE, called ‘kissing sign’, accompanied by subretinal and/or intraretinal fluid (figure 8).…”

Section: Introductionmentioning

confidence: 99%

Guidelines for the management of neovascular age-related macular degeneration by the European Society of Retina Specialists (EURETINA)

Schmidt‐Erfurth

Chong

Loewenstein³

et al. 2014

Br J Ophthalmol

530

456

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Age-related macular degeneration (AMD) is still referred to as the leading cause of severe and irreversible visual loss world-wide. The disease has a profound effect on quality of life of affected individuals and represents a major socioeconomic challenge for societies due to the exponential increase in life expectancy and environmental risks. Advances in medical research have identified vascular endothelial growth factor (VEGF) as an important pathophysiological player in neovascular AMD and intraocular inhibition of VEGF as one of the most efficient therapies in medicine. The wide introduction of anti-VEGF therapy has led to an overwhelming improvement in the prognosis of patients affected by neovascular AMD, allowing recovery and maintenance of visual function in the vast majority of patients. However, the therapeutic benefit is accompanied by significant economic investments, unresolved medicolegal debates about the use of off-label substances and overwhelming problems in large population management. The burden of disease has turned into a burden of care with a dissociation of scientific advances and real-world clinical performance. Simultaneously, ground-breaking innovations in diagnostic technologies, such as optical coherence tomography, allows unprecedented high-resolution visualisation of disease morphology and provides a promising horizon for early disease detection and efficient therapeutic follow-up. However, definite conclusions from morphologic parameters are still lacking, and valid biomarkers have yet to be identified to provide a practical base for disease management. The European Society of Retina Specialists offers expert guidance for diagnostic and therapeutic management of neovascular AMD supporting healthcare givers and doctors in providing the best state-of-the-art care to their patients.Trial registration numberNCT01318941.

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Section: Introductionmentioning

confidence: 99%

Guidelines for the management of neovascular age-related macular degeneration by the European Society of Retina Specialists (EURETINA)

Schmidt‐Erfurth

Chong

Loewenstein³

et al. 2014

Br J Ophthalmol

530

456

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“…The correspondence between the CNV and the 'intraretinal dense zones' and the exact correspondence between 'en face' OCT images and angiograms were clearly demonstrated [4].…”

Section: Coscas · Coscasmentioning

confidence: 98%

“…Downloaded by: University of Hong Kong 198.143.53.1 -8/18/2015 12:25:31 AM brane and the RPE towards the subretinal space, associated to the sub-and intraretinal dense area and serous subretinal fluid (SRF) (fig. 7)[4].…”

mentioning

confidence: 98%

‘En Face' Optical Coherence Tomography with Enhanced Depth Imaging of Different Patterns of the Choroidal Neovascular Network in Age-Related Macular Degeneration

Coscas¹,

Coscas²

2014

Optical Coherence Tomography

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The purpose of this study was to develop a method of segmentation using 'en face' spectral domain-optical coherence tomography (SD-OCT) ('en face' C-scans) to evaluate different patterns of the choroidal neovascular network (CNV) due to age-related macular degeneration (AMD). Materials and Method: A series of 90 patients with AMD comprising 30 cases of subfoveal fibrovascular pigment epithelial detachment, 15 cases of classic CNV and 35 cases of polypoidal choroidal vasculopathy. Fluorescein angiography, indocyanine green angiography and OCT (Spectralis, Heidelberg, Germany) images were analyzed. Volume acquisition of 97 enhanced depth imaging sections at 30-µm intervals was obtained, with a sum of 9 images for each retrofoveal scan. The image was superimposed on infrared and SLO ICG images to confirm the neovascularization. Results: Conventional SD-OCT only provides anteroposterior planes that only visualize the exudative reaction of the neovascular network. This new 'en face' SD-OCT technology allows analysis of not only the contours and the shape of the detachment but also, and most importantly, visualizes the choroidal neovascular network in different patterns due to AMD. This imaging is obtained by means of an 'en face' frontal mode with dynamic analysis in video or on frozen images, section by section, compared to standard SD-OCT or ICGA images with point-by-point correspondence. Conclusion: Until now, the CNV itself was not precisely detectable on conventional SD-OCT but only suggested by an exudative reaction. This new 'en face' SD-OCT technology with dynamic segmentation of the macula allows to visualize the contours and the shape of the fibrovascular pigment epithelial detachment as well as the CNV in fibrovascular pigment epithelial detachment. SD-OCT can demonstrate direct signs of CNV within a pigment epithelial detachment and their localization, seen for the first time on OCT, without injection of dye in patients with a stable fixation point 'en face' and will bring help for the easy detection of CNV and the decision for retreatment easier. 'En face' OCT of classic CNV in AMD also allows to determine the origin of the CNV at the level of the choriocapillaris, the precise location of the 'effraction' of the Coscas G, Loewenstein A, Bandello F (eds): Optical Coherence Tomography.

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“…Stevens and associates 43 similarly reported that the presence of classic CNV increases Histologically, it is expected that type 2 CNV may evolve into subretinal fibrotic lesions (type B). However, Dolz-Marco and associates 44 and Coscas and associates 45 have shown that type 2 CNV lesions treated with intravitreal antiangiogenic therapy may progress to a type 1 CNV fibrovascular pattern. Similarly, in our longitudinal series, we observed two type 2 CNV cases and 1 mixed CNV case evolving into subtype A3, and then following the A / B / C pathway.…”

Section: In This Retrospective Study We Described the Cross-mentioning

confidence: 99%

Spectral-Domain Optical Coherence Tomography Analysis of Fibrotic Lesions in Neovascular Age-Related Macular Degeneration

Souied

Addou-Regnard

Ohayon

et al. 2020

American Journal of Ophthalmology

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Combined Fluorescein Angiography and Spectral-Domain Optical Coherence Tomography Imaging of Classic Choroidal Neovascularization Secondary to Age-Related Macular Degeneration Before and After Intravitreal Ranibizumab Injections

Cited by 18 publications

References 23 publications

Guidelines for the management of neovascular age-related macular degeneration by the European Society of Retina Specialists (EURETINA)

Guidelines for the management of neovascular age-related macular degeneration by the European Society of Retina Specialists (EURETINA)

‘En Face' Optical Coherence Tomography with Enhanced Depth Imaging of Different Patterns of the Choroidal Neovascular Network in Age-Related Macular Degeneration

Spectral-Domain Optical Coherence Tomography Analysis of Fibrotic Lesions in Neovascular Age-Related Macular Degeneration

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