Purchase this article with an account.
Jan H de Jong, Boy Braaf, Sankha Amarakoon, Leah S Wilk, Koenraad Arndt Vermeer, Mirjam EJ Van Velthoven, Tom Missotten, Johannes F de Boer; Visualization of transretinal blood flow in retinal angiomatous proliferation with phase-resolved Doppler-OCT. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4969.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To visualize intra- and transretinal blood flow in patients with retinal angiomatous proliferation (RAP) using high resolution Doppler-OCT. Advanced stages of RAP respond better to a combination therapy with photodynamic therapy and intravitreal anti-VEGF or triamcinolone than to anti-VEGF monotherapy which is the standard treatment for the more common classic or occult choroidal neovascularisations (CNV) in age-related macular degeneration. It is important to accurately identify abnormal intraretinal blood flow consistent with RAP to optimize the treatment strategy.
Consecutive case series of ten treatment-naïve patients, median age 79 years (range 65-90), diagnosed on fluorescein angiography (FA) and/or indocyanine-green angiography (ICG) with an RAP lesion in one eye. Patients were imaged with an experimental 1050 nm swept-source phase-resolved Doppler-OCT instrument. To considerably improve Doppler sensitivity, imaging was performed with backstitched B-scans [Braaf B et al, Opt. Express 2012]. Abnormal flow consistent with RAP was defined as intraretinal (intraretinal neovascularisation, IRN) or transretinal (retinal choroidal anastomosis, RCA).
An example of a patient with RCA and subretinal CNV is presented in the figure. In all ten patients abnormal flow on Doppler-OCT was detected. In 5 patients an RCA was found, 3 patients showed an IRN and in 2 patients only a CNV was seen with flow limited to the subretinal space or located in a pigment epithelial detachment.
We were able to visualize intra- and transretinal blood flow consistent with RAP in 8 out of 10 patients. This data in RAP patients shows the significant clinical potential of angiography with Doppler-OCT to accurately distinguish between intra- and subretinal neovascularisations.
This PDF is available to Subscribers Only