Abstract
Purpose: :
To determine the correlation between macular morphology and visual acuity of patients with exudative Age-related Macular Degeneration (AMD) treated with antiangiogenic therapy using Spectral Domain Optical Coherence Tomography (SDOCT).
Methods: :
Retrospective case series. Sixty-five eyes of 63 consecutive patients treated with intravitreal antiangiogenic therapy were included. SDOCT line scans and retinal maps were obtained using a Spectral Domain instrument (OTI SLO/OCT, Opko Health inc.). Linear scans were positioned on the foveal center. SDOCT retinal morphology, including Central Foveal Thickness (CFT), foveal depression profile (FDP) and retinal lines were considered. The aspect of the retinal lines corresponding to the Outer Nuclear Layer (ONL), External Limiting Membrane (ELM), Inner Segment - Outer Segment (IS/OS) junction and RPE complex were graded by two independent experts (UI and MS) as "present": 1, or "absent or altered": 0, and the total score from 0 to 4 was considered. Discrepancies between the two graders were judged with Kappa measure of agreement. Spearman correlations were calculated between: 1) retinal line score and logMAR; 2) CFT and logMAR; 3) retinal line score and CFT.
Results: :
Grader agreement was: K= 0.90. Patients with poor visual acuity have a low grading score (0, 1), corresponding to an ultrastructural morphologic retinal disruption at SDOCT scan; patients with good visual acuity were more likely to maintain the presence of retinal lines with high grading (score 3 and 4) (R=0.78, p< 0.001). No correlation was found between CFT and visual acuity as well as retinal morphology and CFT (NS, p=0.15 and p=0.09 respectively). The presence of a normal FDP does not correspond to visual acuity outcome (p=0.09).
Conclusions: :
SDOCT retinal ultrastructural morphology evaluation appears a promising method to study the functional aspect of AMD antiangiogenic treatment. Further investigation is needed to confirm our observations.
Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • age-related macular degeneration • macula/fovea