Abstract
Purpose: :
To compare the volume of retinal morphological features, quantified using optical coherence tomography (OCT), with fluorescein angiographic classification in patients enrolled in the Avastin (Bevacizumab) for Choroidal Neovascularization (ABC) Trial.
Methods: :
122 cases of previously untreated, subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) were evaluated from the ABC Trial. CNV lesions were classified by investigators at enrollment as classic with no occult, predominantly classic, minimally classic, or as occult with no classic. Corresponding Stratus OCT image sets were analyzed by certified graders at the Doheny Image Reading Center using custom software, entitled "OCTOR". Thickness/volume measurements for the neurosensory retina, subretinal fluid (SRF), pigment epithelium detachment (PED), and subretinal tissue (SRT), were calculated and compared with angiographic lesion classification.
Results: :
The mean thickness of the neurosensory retina at the foveal center point was 269 ± 91 µm. Retinal thickness was greatest in lesions classified as classic with no occult (306 ± 105 µm) and least in minimally classic lesions (258 ± 64 µm). SRF was present at baseline in 104 (85%) eyes and had a total volume of 0.55 ± 1.16 mm3. SRF volume was greatest in classic with no occult lesions (0.72 ± 1.15 mm3), and least in minimally classic lesions (0.39 ± 0.48 mm3). PED was present at baseline in 104 (85%) eyes and had a total volume of 0.78 ± 0.92 mm3. PED volume was greatest in occult (0.91 ± 0.99 mm3) or minimally classic lesions (0.95 ± 0.99 mm3), and least in classic with no occult lesions (0.16 ± 0.38 mm3). SRT was present at baseline in 109 (89%) of eyes and had a total volume of 0.56 ± 0.61 mm3. SRT volume was greatest in classic with no occult lesions (1.09 ± 0.90 mm3), and least in occult with no classic lesions (0.30 ± 0.44 mm3).
Conclusions: :
Quantitative OCT subanalysis allows for an improved understanding of the structural characteristics of angiographically defined CNV lesions. OCT plays a critical role in the diagnosis and treatment of patients with neovascular AMD - in the future, hybrid classifications of CNV, based on OCT and fluorescein angiographic parameters, may be of use in clinical trials of this disorder.
Clinical Trial: :
www.ISRCTN.org 83325075
Keywords: age-related macular degeneration • imaging/image analysis: clinical • choroid: neovascularization