Purpose:
To demonstrate the use of optical coherence tomography (OCT) analysis software to quantify the effect of intravitreal anti-VEGF therapy on retinal pigment epithelial detachments (RPEDs) related to wet age-related macular degeneration (AMD) and to correlate RPED volume change with visual acuity.
Methods:
A retrospective analysis was performed on 20 eyes of 20 patients with RPEDs treated with multiple injections of intravitreal ranibizumab (Lucentis; Genetech Inc., South San Francisco, CA) and/or bevacizumab (Avastin; Genetech, Inc.) for wet AMD. Patients were followed by clinical exam, angiography, and OCT. Manual re-segmentation was performed on 128 B-scans of a 512X128 macular cube scan using Cirrus HD-OCT software (Carl Zeiss Meditec,Inc., Dublin, CA) to define RPED volumes over multiple visits. The Cirrus generated volumes were correlated to visual acuity.
Results:
Volumes were measured over an average 5.5 month period (range 2-15 months) and an average of 3 measurements performed per patient. Patients received on average 1.8 intravitreal anti-VEGF injections in the affected eye during the measurement interval. OCT defined volumes showed a mean RPED volume change of 0.43mm3 (n=20, SD=1.14) from a baseline of 1.4mm3 with 60% of eyes demonstrating no change in volume over the measured time interval. Statistical analysis showed a weak trend toward correlation between visual acuity and RPED volume (r=0.25).
Conclusions:
This study introduces a simple method for quantifying RPED volume over the course of treatment without the use of custom software. OCT findings suggest that RPEDs persist despite anti-VEGF therapy and their presence is not strongly correlated to visual acuity in wet AMD. Re-segmentation may be a valuable clinical tool to quantify subretinal fluid accumulations in wet AMD and other conditions such as central serous chorioretinopathy, and to provide a better understanding of anatomic outcomes and their correlation to visual acuity.
Keywords: imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • imaging/image analysis: clinical • age-related macular degeneration