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H. Tabandeh, N. A. Chaudhry, V. Konjara, T. Chu, D. Boyer, R. Novack, F. Rahhal, J. Hopkins, R. Roe, P. Dayani; Fundus Fluorescein Angiography (FA) Complements OCT in Detecting Active Leakage in Patients With Exudative AMD. Invest. Ophthalmol. Vis. Sci. 2010;51(13):529.
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Background: Management of exudative AMD currently includes monthly intravitreal administration of anti-VEGF agents until the resolution of intra and subretinal fluid as observed on OCT. Once the OCT demonstrates absence of fluid, a drug-free interval is often considered. Although presence of intra and subretinal fluid on OCT likely represents accumulation of fluid due to active leakage from CNV complex, absence of fluid on OCT may not represent absence of active leakage. Physiological processes such as the "RPE pump" may successfully cope with subtle degrees of leakage, preventing accumulation of fluid that is detectable on OCT.
To study presence of leakage on FA in patients with exudative AMD who demonstrate resolution of intra and subretinal fluid on OCT following anti-VEGF therapy.
Observational case series. Patients undergoing treatment for exudative AMD who demonstrated resolution of subretinal and retinal fluid on OCT (td or sd), underwent FA prior to considering a drug-free interval. Outcome measures included presence of leakage on FA and change in the size and composition of CNV complex.
Thirty one eyes were included in the study; 8 eyes (26%) demonstrated active leakage on FA while the OCT had not demonstrated evidence of intraretinal, sub-retinal, or sub-RPE fluid.
In the setting of exudative AMD, subtle degrees of leakage from CNV may not result in accumulation of intra and subretinal fluid detectable by OCT. FA is valuable in detection of leakage when OCT fails to show fluid and a drug-free interval is being considered. High resolution OCT may detect subtle degrees of fluid in some of these case.
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