Abstract
Purpose: :
Optical Coherence Tomography (OCT) has advanced in recent years. Due to the convenience of OCT, there has been a trend to move away from using fluorescein angiography (FA) as the primary diagnostic modality in neovascular age-related macular degeneration (AMD). We propose to show that flourescein angiography still has a necessary role in evaluation and treatment of AMD, particularly during follow-up.
Methods: :
A retrospective chart review in a busy retina specialty clinic was performed to find patients with neovascular AMD. Spectral-domain OCT (SD-OCT) and FA were evaluated. The SD-OCT and FA results were then compared.
Results: :
We present three separate cases of neovascular AMD, in treated patients who were considered stable. All three patients noted changes in their vision. These changes were initially evaluated with SD-OCT. There was no evidence of intraretinal or subretinal fluid on SD-OCT. Upon further evaluation all three were found to have active fluorescein leakage and treated accordingly.
Conclusions: :
A literature search was performed, and few studies compare OCT and FA in identifying active disease in neovascular AMD. These studies show that OCT, particularly SD-OCT, is fairly sensitive at detecting intraretinal or subretinal fluid; however, there is low specificity. OCT has added a great deal of convenience for the patient and the physician. Although OCT has made great strides there is still room for improvement. Clinicians need to be careful not to solely rely on OCT for guidance in management of neovascular AMD particularly in treated disease.
Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • age-related macular degeneration • neovascularization