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C. Ahlers, A. Beckendorf, S. Michels, U. Schmidt-Erfurth; Correlation of Topographic Angiography (TAG), Retinal Thickness Analysis (RTA) and Optical Coherence Tomography (OCT) . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1768.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To document chorioretinal changes in classic types of chorioretinal disease using three different imaging modalities with the aim to identify specific pathognomonic features and to evaluate advantages/ disadvantages of each method. Methods: 104 eyes of 104 patients demonstrating active chorioretinal disease were included: drusen in age-related macular degeneration (AMD), classic and occult choroidal neovascularization (CNV), serous pigment epithelium detachment (PED), diabetic maculopathy (DMP), branch artery or vein occlusion (BRAO/BRVO) and central serous retinopathy (CSR). Three-dimensional topographic angiography (Heidelberg Retina Angiograph), RTA (Talia Technologies) and OCT (Humphrey Systems) were used for comparative imaging. Results: Drusen were clearly demarcated as localized fluid pools by TAG and appeared as wave-like band of RPE prominences by OCT scanning, while no changes were detected by RTA or OCT mapping. In serous PED a large, well-defined fluid accumulation with dynamic filling was observed by TAG, OCT imaging was static, but identified the site of the fluid pooling in the sub-RPE space; RTA delineated the borders of the lesion only. The neovascular component of classic CNV was precisely identified only by TAG, while OCT demonstrated variable stages of RPE thickening. However, cystic changes and extravasate within/ underneath the retina was well documented by OCT scans only. Occult CNV was identified and precisely delineated by TAG, while OCT and RTA failed to detect occult, sub-RPE lesions. CSR appeared as well-demarcated fluid pooling by TAG, but only OCT allowed the subretinal localization of the exudate. Intraretinal edema as a results of intensive retinal vascular leakage in BRVO/BRAO was best imaged by TAG, while RTA and OCT did not document the extension of the affected area. Detection of mild intraretinal leakage was superior in RTA, TAG achieved no documentation and OCT mapping was not precise. Perfusion defects on the level of the choroid were exclusively detected by TAG and did not appear in RTA or OCT imaging. Conclusion: All three imaging modalities offer relevant diagnostic aspects, which are often complimentary. TAG identifies neovascular complexes and perfusion changes, even below the level of the RPE. OCT scans precisely image intraretinal changes, but are limited to pathologies above the RPE. RTA was most informative in detecting retinal edema in DMP.
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