Abstract
Purpose: :
To evaluate the fovea morphologically using optical coherence tomography (OCT) for making indications for autologous transplant of retinal pigment epithelium and choroid in retinal pigment epithelium tears due to exudative AMD.
Methods: :
Retrospective chart analysis of fluorescein angiography images from the year 2001 to 2009 in the university eye hospital in Cologne, Germany. Seventy four patients (79 eyes) with pigment epithelium tears secondary to age related macular degeneration were identified. Optical coherence tomography was done either using time domain stratus OCT (Carl Zeiss Meditec Model 3000 equipped with software version 4.0, Zeiss-Humphrey, Zeiss, Oberkochem, Germany) or using spectral domain OCT (Heidelberg Engineering GmbH, Dossenheim, Germany). The fovea was classified either as still supported by the retinal pigment epithelium (RPE) or not.
Results: :
Optical coherence tomography images were available from 46 eyes (21 stratus OCT and 25 spectral domain OCT). The fovea could not be seen in 5 (11.36%) cases due to cystoid macular edema involving the fovea, in 2 (4.55%) cases due to bad image quality, in 4 (9.09%) cases due to eccentric fixation, therefore the fovea was not scan in stratus OCT or combination of them in 3 (6.82%) cases. Of the remaining 32 eyes, the fovea was still supported by the RPE in 19 cases. In 13 cases there was no RPE support.
Conclusions: :
Spectral domain OCT and in certain cases time domain stratus OCT can identify the fovea in pigment epithelium tears. Cystoid macular edema involving the fovea or eccentric instable fixation complicate this process though. Spectral domain OCT images in patients with pigment epithelium tear can help selecting patients suitable for autologous transplant of retinal pigment epithelium and choroid.
Keywords: age-related macular degeneration • imaging/image analysis: clinical • retinal pigment epithelium