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Gabriel Coscas, Florence Coscas, Eric Souied; “En face” OCT for retreatment indications during follow up of Vascularized Pigment Epithelium Detachment in Exudative Age related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3599.
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© ARVO (1962-2015); The Authors (2016-present)
The purpose of this study, with ”En Face” OCT was to evaluate reproducibility of a recent software for segmentation of the retina to recognize during post treatment follow up either the fibrosis of choroidal neovascular network or the recurrence or persistence of exudation.
49 patients with FV-PED in macular degeneration (AMD) treated with intravitreal injection of Ranibizumab (PRN)and followed up during one year were included. Diagnosis was suggested on: FA+ICGA+SD-OCT (Spectralis, Heidelberg Engineering, Germany).Volume acquisition (97 EDI-OCT sections of 9 averaged B-scans at 30 µm intervals, generating 496 C-scans), was obtained, in 60 seconds. The image was cropped on ICG to confirm the neovascularization. Reproducibility intra and inter observer were evaluated (2 senior observers).
Reproducibility intra and inter observer were 98% and 94% with “en face” OCT versus B- Scan OCT. After one year treatment with anti VEGF Injections, the branching network with small ramifications was detectable only if there is still subretinal fluid. The hyper-reflective course of type 1 CNV is progressively masked due to progressive fibrosis of the FV-PED. Fluid accumulation was present at inclusion, in all 49 FV PED. At one year, presence of fluid was doubtful or not detected on B-Scan in 16/49 cases. On C- Scan, presence fluid was recognized, easily detectable, in 10 cases. C-Scan disclosed extension or recurrence, in 6 other cases
C -Scan OCT, during follow up, allows easy detection of the recurrence or persistence of exudation, even easier and better than B-Scan OCT. This new “En Face” OCT technology allows to visualize the contours and the shape of the FV-PED, the choroid neovascular network in the FV-PED without dye. “En Face” SD-OCT demonstrates for the first time, directs signs of choroidal neovascularization, allows overlay and measurement of area of lesion of fibrovascular PED. Disclosure: None
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