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Sandra Liakopoulos, Tina Ristau, Pearse A. Keane, Bernd Kirchhof, Alexander C. Walsh, Srinivas R. Sadda; Photoreceptor Delamination In Choroidal Neovascularisation. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2134.
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© ARVO (1962-2015); The Authors (2016-present)
To demonstrate a novel optical coherence tomography (OCT) finding in eyes with choroidal neovascularization (CNV) and it's implication on retinal sensitivity.
We identified 6 eyes of 6 patients with previously untreated neovascular AMD and 1 eye of one patient with idiopathic CNV demonstrating the OCT finding that we propose to term "photoreceptor delamination". SDOCT images were inspected and volume and area of the photoreceptor delamination was measured using manual grading software (3D OCTOR). In one case, microperimetry was performed at baseline and at 9 months follow-up.
Visual acuity ranged from 20/400 to 20/50. Fundus photographs demonstrated subretinal hemorrhage in 5 out of 7 eyes. On SDOCT, outer segments of the photoreceptors were visualized as a continuous band, which then appeared to split from the retina, dropping down towards the retinal pigment epithelium (RPE). The mean area affected by the delamination was 2.46±2.87 mm²; the mean volume was 0.19±0.12 mm³. Follow-up was available for 4 to 17 months. All cases demonstrated the photoreceptor delamination only at one time point, suggesting that the finding was a relatively transient phenomenon. One case demonstrated reduced retinal sensitivity on microperimetry in the area of the delamination at baseline, and complete recovery of outer retinal layers with improved retinal sensitivity 9 months later following 4 bevacizumab injections.
Delamination of the outer photoreceptor band in eyes with CNV could be identified using high resolution OCT. The splitting occurred mainly in eyes demonstrating subretinal hemorrhage. We could illustrate that this phenomenon may be transient and that morphology and function may recover after delamination.
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