Purchase this article with an account.
Christina Ryu, Natalia Vila, Amer Omar, John C Chen; Outer retinal tubulations in exudative age-related macular degeneration: baseline fluorescein angiography and spectral-domain optical coherence tomography findings. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5375.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
The cause of outer retinal tubulations (ORTs) is not clear. They occur in a variety of conditions leading to outer retinal degeneration, most frequently in the cicatricial stage of wet age-related macular degeneration (wet AMD). We wish to study the pathogenesis of ORT in anti-VEGF-treated wet AMD eyes by examining their presenting angiographic and OCT features.
Consecutive cases of eyes treated with anti-VEGF agent were reviewed. Eyes with subfoveal fibrotic scars without signs of active neovascularization were included. They were divided into two groups depending on the presence of ORTs. Imaging studies, including initial fluorescein angiogram and OCT, as well as the series of OCTs prior to each anti-VEGF treatment visit, were evaluated for following information: type and size of initial neovascular membrane, presence of blocked fluorescence, drusen type, presence of subretinal hyperreflective material, time of onset of ORTs, and their evolution during the course of treatment.
Twenty six of 56 eyes (46.4%) with stable fibrotic scars were found to have ORTs. Of these 26 patients with ORTs, FA evaluation showed 19 eyes (73.1%) had type 1 membranes and 7 (26.9%) had type 2 membranes. None had type 3 membranes. On SD evaluation, 100% had subretinal hyperreflective material. Using SD OCT to classify lesion type, 72.7% had type 2 lesion, and 27.3% had type 3 lesion; none were type 1 lesions by SD OCT.
In anti-VEGF-treated eyes that have a stable fibrotic scar, ORTs can be found in approximately in 46%. Some subretinal component of CNVM seems to be important in their pathogenesis. The possible cause of tubule formation will be discussed.
This PDF is available to Subscribers Only