Spectral-Domain versus Time Domain Optical Coherence Tomography before and after Ranibizumab for Age-Related Macular Degeneration

Abstract

Purpose: To study the ability to appreciate qualitative features that indicate disease activity in patients with neovascular age-related macular degeneration (AMD) and to analyze the differences in automated retinal thickness measurement, using 1 time domain optical coherence tomography (TD-OCT) and 2 different spectral-domain OCT (SD-OCT) machines. Methods: Thirty-three consecutive naïve patients with neovascular AMD underwent Stratus TD-OCT, Cirrus SD-OCT and Spectralis SD-OCT, at baseline, 1 h, 1 day, 1 week and 1 month after intravitreal ranibizumab injection. Results: As regards the ability to detect retinal cysts, subretinal fluid and pigment epithelium detachment, at each follow-up visit, there was a significant correlation among all 3 OCT devices (p < 0.05), even though Cirrus SD-OCT and Spectralis SD-OCT showed the highest level of intermachine agreement. At each follow-up visit, automated retinal thickness measurements showed a greater mean central macular thickness (CMT) for both Spectralis SD-OCT and Cirrus SD-OCT, compared with Stratus TD-OCT. However, the mean paired differences in CMT among the 3 OCT devices were not statistically significant (p > 0.05). Overall, Cirrus SD-CT showed fewer segmentation errors, compared with both Spectralis SD-OCT and Stratus TD-OCT. Conclusion: SD-OCT showed a greater ability to evaluate qualitative features indicating disease activity and fewer errors in automated segmentation. However, differences in CMT changes were similar between TD-OCT and SD-OCT systems during follow-up.

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

“…In a ‘real life’ PRN protocol, all these features are usually considered as criteria for reinjection of anti-VEGF substances. Compared with the former TD-OCT technology, current SD-OCT or SS-OCT technologies which provide raster-scanning imaging, are more sensitive for detecting of subtle morphological changes and, thus, permit early treatment of exudative recurrence 59 60. The common recommendation is, therefore, to monitor disease activity using SD-OCT, and on a monthly base.…”

Is Spectral-Domain Optical Coherence Tomography Essential for Flexible Treatment Regimens with Ranibizumab for Neovascular Age-Related Macular Degeneration?

“…Querques et al compared the ability of the 2 SD-OCT and TD-OCT devices in detecting the disease activity in the nAMD patients [22]. The patients were evaluated at different time points after IVR injection.…”

Die Anti-VEGF-Therapie bei der neovaskulären altersabhängigen Makuladegeneration: therapeutische Strategien

“…Wie beschrieben sind insbesondere mit einem SD-OCT-basierten PRN-Wiederbehandlungsschema ähnliche Visusergebnisse mög-lich wie mit monatlicher Applikation [17,23,25]. Die neue SD-OCT-Technik ermöglicht eine sichere Lokalisation und Vergleichbarkeit der morphologischen Parameter.…”