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Philipp Ken Roberts, Bernhard Baumann, Christopher Schütze, Stefan Sacu, Matthias Bolz, Michael Pircher, Christoph K Hitzenberger, Ursula Schmidt-Erfurth; . Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2793.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate morphological retinal pigment epithelium (RPE) alterations in fellow eyes of patients diagnosed with unilateral neovascular age-related macular degeneration (nAMD) using polarization-sensitive optical coherence tomography (PS-OCT).
Thirty-one fellow eyes of 31 consecutive patients with unilateral nAMD were included in this prospective observational case series. PS-OCT was performed at baseline, month 1, months 3, 6 and 12 and every 12 months thereafter and whenever significant RPE-changes were diagnosed clinically. Conventional imaging systems including spectral-domain (SD-)OCT and fluorescein angiography (FA) were used for comparative imaging. Morphological features associated with the development of choroidal neovascularization (CNV) were analyzed.
Mean follow-up was 29 months ±17 months. Thirteen (42%) of 31 eyes developed de novo CNV: 9 eyes type I CNV, 2 eyes type II CNV, 2 eyes a RAP lesion. Reticular pseudodrusen, readily identifiable by PS-OCT, were observed in 10 of the 13 eyes (77%) that progressed towards CNV and only 3 of 18 eyes (17%) that did not develop CNV. Monthly increases in drusen area and volume, measured by PS-OCT, were higher in the CNV group compared with the group not developing CNV.
Progression of early AMD to CNV is preceded by qualitative and quantitative RPE alterations. An increase in drusen area/volume may be an indicator for progression to nAMD. PS-OCT may represent a useful tool for individual risk stratification and early CNV detection.
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