Purchase this article with an account.
V. Manjunath, J. S. Duker, J. G. Fujimoto; A Simple Method for Performing Quantitative Analysis of Retinal Pigment Epithelial Detachments in Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2010;51(13):300.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
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.
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.
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).
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.
This PDF is available to Subscribers Only