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M.E. Farah, R.A. Costa, D. Calucci, T.A. Guia, A.L. Höfling-Lima, R. Belfort Jr; New Stratus® OCT Findings in Neovascular AMD Following Verteporfin PDT . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1766.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To describe the morphological changes occurring in the macular region of patients with exudative age-related macular disease (AMD) who were submitted to photodynamic therapy (PDT) with verteporfin. Methods: A total of 32 consecutive AMD patients presenting predominantly classic or occult CNV were retrospectively reviewed. Optical coherence tomography (OCT) using Stratus® device as well as fluorescein and indocyanine green angiography were performed within 7 days of treatment, and 6 and 12 weeks after PDT. Results: Before treatment, predominantly classic lesions were present in 20 eyes whereas occult lesions were observed in 18 eyes. OCT disclosed subfoveal involvement in two eyes with predominantly classic lesions in which fluorescein angiography had suggested a juxtafoveal location. Only classic lesions larger than 1mm in diameter presented a fusiform thickning of the RPE/choriocappilaris complex with definitive bondaries associated to increased retinal thickness and presence of subretinal fluid. Occult lesions consistently presented a somewhat variable dome-shaped elevation of the RPE/choriocapillaris complex, usually with a detectable split between its two layers rather than significative retinal thickness or subretinal fluid accumulation. After treatment, restoration of a near-normal fovea contour was noted in 6 weeks in 14 eyes (70%) with predominantly classic and in 9 eyes (50%) with occult CNV although in 12 weeks it was present in 6 eyes (30%) with predominantly classic against 8 eyes (44.4%)with occult lesions. Usually, in the predominantly classic, the fusiform pattern continued present, whereas in the occult CNV, the complex elevation faded gradually according to leakeage decreaseness. Conclusion: The new Stratus OCT® examination appears to be usefull as an auxiliary method in the differentiation of juxta or subfoveal lesions as well as in the characterization of distinct patterns of response from predominantly classic and occult CNV following PDT with verteporfin. Predominantly classic lesions showed a more rapid regression but a late reativation, whereas occult CNV presented a more slow and progressive reaction during the 3 month observation.
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