Using Optical Coherence Tomography to Monitor Photodynamic Therapy in Age Related Macular Degeneration

Relationships between clinical measures of visual function and anatomic changes associated with bevacizumab treatment for choroidal neovascularization in age-related macular degeneration

“…High contrast VA does not evaluate the limits of vision under conditions that are associated with activities of daily living. 11 The evaluation of vision parameters other than distance acuity has been limited. Moutray 7 evaluated near word acuity and Pelli-Robson contrast sensitivity, and found stronger relationships with the anatomic parameters than distance VA.…”

Re-Treatment Strategies for Neovascular AMD: When to Treat? When to Stop?

“…They have found that OCT was considered as positive (presence of sub-retinal fluid and/or intraretinal fluid) in 14.2% of the cases in which FA did not show clear leakage. On the other hand, most of the cases with positive OCT findings without any leakage on FA (false positives) had a disciform scar with persistent cystic cavities on OCT (Salinas-Alamán et al, 2005). It can be concluded that if there is no fibrotic scar visible during the fundus examination, the presence of remaining fluid on the OCT scan may indicate residual lesion activity.…”

“…This approach has emerged especially after anti-VEGF treatments of neovascular AMD lesions to avoid from monthly FA. Once the diagnosis of neovascular AMD was established with FA before treatment, OCT was reported to have a sensitivity of 96% for detecting lesion activity and a diagnostic efficiency (proportion of correct results) of 83% (Salinas-Alamán et al, 2005). However, OCT cannot detect other features including blood, lipid, and vascular patterns so effectively.…”

“…OCT is a very important indicator of neovascular AMD activity and may be assumed as the main determinant for deciding the need for re-treatment in patients with AMD. Recently, there is a tendency to assess the activity of neovascular AMD lesions with only OCT without performing FA after the initial assessment Cohen et al, 2007;Rosenfeld et al, 2006b;Salinas-Alamán et al, 2005). This approach has emerged especially after anti-VEGF treatments of neovascular AMD lesions to avoid from monthly FA.…”

“…Within the last decade OCT has emerged and enhanced our understanding in many central retinal diseases. For AMD, OCT appears to be useful for evaluating the responses of the retina and retinal pigment epithelium (RPE) to the treatment (Cohen et al, 2007;Eter & Spaide, 2005;Fung et al, 2007;Krebs et al, 2008;Lalwani et al, 2009;Salinas-Alamán et al, 2005;Schmidt-Erfurth et al, 2007;van Velthoven et al, 2006;). Clinical trials have shown that in the two thirds of patients requiring ranibizumab therapy because of recurrent neovascularization, OCT seemed to detect early anatomic changes in the macula before any vision loss (observation during the extension trials of phase I-II studies by P. Rosenfeld: unpublished data).…”