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A. J. Lavaque, W. Arellano, B. Delgado, J. Garzon, P. Navarro, N. Chaudhry, P. Liggett; Age-Related Macular Degeneration: The Limit Between Dry and Wet. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4375.
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Aim: to describe a, previously unrecognized, tomographic sign in patient with AMD and to demonstrate the value as a clinical marker of early wet conversion.
Twelve eyes, of 10 patients, with high risk dry-AMD were followed closely during a 12 month period of time. Patients were followed monthly by BCVA determination, biomicroscopy, fluorescein angiography and TD-OCT (Stratus-OCT). During the follow-up two eyes, in 2 different patients, experimented conversion to wet-AMD (defined as the presence of sub or intraretinal fluid). The recorded data of these patients were retrospectively evaluated and compared with the non-converted group.
Both eyes developed an "areflective (empty space) submacular choroidal fracture" usually related with a PED and only detected by OCT. Lesion was associated with minor or no changes of BCVA. The described choroidal lesion was named as: localized adquired choroidal detachment (LACD) and was not seen, during the follow-up, in any of the non-converted eyes. The LACD was followed by the later accumulation of subretinal fluid in both eyes, thus reaching current treatment criteria.
A previously unrecognized tomographyc sign, in AMD patients, was described. OCT-images suggest that LACD could be the first detectable clinical sign in patients suffering of AMD conversion, even before BCVA alteration. More studies are guaranteed in order to confirm this appreciation.
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