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Claudia Orini, Lucia Lonati, Andrea Giani, Giulia Fusetti, Mario Cigada, Giovanni Staurenghi; Fundus Autofluorescence And Spectral Domain Optical Coherence Tomography Features After Development Of Retinal Pigment Epithelium Tears. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5146.
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© ARVO (1962-2015); The Authors (2016-present)
To describe retinal features after development of retinal pigment epithelium (RPE) tears in patients affected by neovascular age related macular degeneration (AMD), by using fundus autofluorescence (FAF) and spectral domain optical coherence tomography (SD-OCT).
Retrospective review of FAF and OCT images of 11 consecutive patients (11 eyes) with neovascular AMD who developed RPE tears after anti-vascular endothelial growth factor (anti-VEGF) therapy. Of the 11 patients, 7 were females and 4 males. Mean age was 74 years (range 53-83 ). Patients underwent clinical biomicroscopic examination, FAF ( 488 nm) using a confocal scanning laser ophthalmoscope (SLO, HRA-Heidelberg Engineering, Germany) and SD-OCT (Spectralis OCT, Heidelberg Engineering, Heidelberg, Germany and Cirrus HD OCT, Carl Zeiss Meditec, Inc., USA). FAF and SD-OCT images were analyzed by two independent examiners. FAF hypofluorescent areas correspondent to RPE denudation were measured using the Spectralis software. SD-OCT images were analyzed to assess the regrowth of RPE layer on the denudated area.
Within a 6-months follow-up period, a progressive reduction of 21% (range 1.94%-58.99%) of the hypoautofluorescent area was observed on FAF images.The strength of agreement between the two observers in the area measurement was significant at baseline (ICC= 0,997; 0,99<ICC<0.999) and at 6 months of follow-up (ICC= 0,995; 0,983<ICC<0,999). Visual acuity (VA) remained stable (4 patients) or worsened over time. Mean VA was 0.3 logMar at baseline (range 0-0.7) and 0.5 logMar after 6-months (range 0.1-1). On the contrary, signs of regrowth of RPE layer from the border of the tear were not clearly detectable on SD-OCT images. Only one patient showed a correlation between the reduction of hypoautofluorescence and the decrease of backscattering signal corresponding to the RPE denuded area.
This study shows that the hypoautofluorescent area after RPE tears may reduce over time. This reduction does not seem to be correlated to an increase in visual acuity. SD-OCT images may suggest that the reduction of hypoautofluorescent area corresponds to RPE regrowth. However, the visualization of RPE in SD-OCT is not always visible in these patients, due to severe exudation.
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