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Showrob N. Patwary, Samir Dowlut, Yit C. Yang, Niro Narendran; Optical Coherence Tomography Of Very Early Development Of Outer Retinal Tubulation In Wet AMD Lesions. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3680.
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Outer Retinal Tubulation (ORT) has been described in a variety of macular lesions including WET AMD. Serial optical coherence tomography (OCT) scanning in patients undergoing treatment with ranibizumab provides an opportunity to study very early OCT features of ORT. Our objective was to describe very early OCT changes prior to the appearance of established ORT in order to understand the stages of ORT formation.
We retrospectively reviewed the OCT scans for 65 patients receiving more than ten intravitreal ranibizumab injections for the presence of tubules. When identified, we specifically studied the sequential development of these tubules in order to describe their early microstructural features and sequences in their formation.
Retinal tubules were identified in 15 patients. In 10 patients there was not sufficient imaging data to identify the early features. We present 5 cases in which it was possible to follow the sequences of ORT formation including the early stage of photoreceptor layer cleaving which may be the precursor to ORT formation.
The OCT findings in this study support the theoretical hypothesis that ORT formation begins at the photoreceptor layer. In some cases it is possible to track formation of ORT from an early stage. This provides future opportunity to study the clinical implications of ORT formation.
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