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F. Faria-Correia, R. Barros-Pereira, L. Queiros-Mendanha, L Mendonca, S. Fonseca, M. Falcao, E. Brandao, A. Carneiro, F. Falcao Reis; Outer Retinal Tubulations in Exudative Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1783.
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To characterize Neovascular Age-related Macular Degeneration (AMD) patients with Outer Retinal Tubulations (ORT) identified with spectral-domain OCT (HRA-OCT).
Retrospective study of 377 eyes, 323 patients with Neovascular AMD, treated with intravitreal anti-VEGF agents. Baseline assessment included Best Corrected Visual Acuity (BCVA) with ETDRS charts, Fluorescein Angiography (FA) and OCT (HRA OCT - Heidelberg Enginneering). All patients were evaluated every 4 weeks. Criteria for retreatment included intra-retinal or subretinal fluid or serous pigment epithelium detachment on OCT or new (or persistent) leakage in FA or new (or recurrent) intra-retinal or subretinal hemorrhage. For statistical analysis, the Independent sample T Test and Paired sample T Test were used.
ORT were detected in 31 eyes (8.22 %) of 31 patients. The initial mean BCVA was 34.48 (+/-20.20) and the final mean BCVA was 37.65 (+/-19.44). The most frequent FA lesion type identified was the minimally classic (13 eyes), followed by the predominantly classic (8 eyes). There was a mean BCVA increase of 3.16 letters, but it isn't statiscally significant (p=0.33). ORT were not detected in 346 eyes (91.8 %) of 292 patients. The initial mean BCVA was 44.53 (+/-22.6) and the final mean BCVA was 47.18 (+/-23.3). There was a mean BCVA increase of 2.66 letters, which it's statistically significant (p<0.05). The most frequent angiography lesion type identified was occult type 1 (165 eyes)When comparing the patients with ORT with those without ORT, initial and final BCVA were lower in the group with ORT (34.48 vs 44.53 - p<0.05; 37.65 vs 47.18 - p<0.05).
AMD patients with ORT have a worse visual outcome when comparing with AMD patients without ORT, although there is a mean BCVA increase during follow-up in both groups. Our data suggest that ORT might be associated with choroidal neovascularization above retinal pigment, which is more prone to induce direct damage to the photoreceptors layers and to develop subretinal fibrosis.
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