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H. Iwami, M. Yamamoto, T. Kohno, M. Kaida, N. Miki, M. Hirabayashi, A. Hamaguchi, K. Shiraki; Therapeutic Efficacy Using Retinal Pigment Epithelium Elevation Maps in Retinal Angiomatous Proliferation. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4384.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the therapeutic efficacy of combined antivascular endothelial growth factor and photodynamic therapy (PDT) in retinal angiomatous proliferation (RAP) using a retinal pigment epithelium (RPE) elevation map (REM) with Spectral Domain Optical Coherence Tomography (OCT).
Subjects comprised 4 eyes in 4 patients (2 men, 2 women; mean age, 81.3 years) with stage 2 RAP examined in the Department of Ophthalmology at Osaka City University in whom REM measurement was possible. All subjects have received prior treatment for the condition. Combined intravitreal bevacizumab and PDT were administered to patients 1 and 2, while combined intravitreal ranibizumab and PDT were administered to patients 3 and 4. Visual acuity (logMAR) assessment, fluorescein and indocyanine green angiography (FA and IA), and OCT were performed preoperatively and 3 months postoperatively. REM was generated using an RTVue® (Optovue, Inc, Fremont, CA) MM5 protocol and the mean and standard deviation of RPE elevation height (µm) were investigated. If automatic analysis of the REM was insufficient, it was manually adjusted.
Mean visual acuity improved from 0.52 preoperatively to 0.27 postoperatively. Postoperatively, neovascularization disappeared on IA and leakage decreased in FA, and there was a marked reduction in macular edema and RPE detachment on OCT. Decrease of mean and standard deviation of RPE elevation height: from 19.7 to 0.9 and from 38.0 to 2.7 in patient 1, from 168.3 to 16.5 and from 122.5 to 26.5 in patient 2, from 9.3 to 2.3 and from 26.5 to 5.1 in patient 3 ,from 11.3 to -0.1 and from 35.6 to 2.4 in patient 4, respectively.
REM enabled to evaluate RPE elevation height objectively, suggesting the usefulness of REM in investigating therapeutic efficacy in RAP.
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