Retinal Edema Identified by Optical Coherence Tomography Is a Reliable Indicator of Conversion to Wet Age-Related Macular Degeneration

Abstract

Purpose: : To identify in a longitudinal and observational study, the morphological and/or functional features that define the earliest identifiable choroidal neovascularization (CNV) lesion.

Methods: : Fifty-nine patients with unilateral CNV and early age-related maculopathy in the study eye have been followed in an ongoing observational, longitudinal study. These patients have a particularly high risk of developing wet age related macular degeneration (AMD) in the fellow eye, the study eye. Best corrected ETDRS visual acuity (VA), optical coherence tomography (OCT), fluorescein (FA) and indocyanine green angiography (ICG), fundus photography (FP), fundus autofluorescence imaging (FAF) and retinal leakage analysis (RLA) were performed at baseline and every 6 months. The observations made in the study eyes that developed CNV demonstrated by VA loss and signs of alterations in FA during the follow-up are here reported.

Results: : Twenty-five of 59 patients completed 18 months of follow-up at the time of this report. Eight patients developed CNV in the fellow eye. OCT was normal in every one of these eyes before development of CNV, and showed clearly the presence of retinal edema in every one of these eyes at the time of conversion and development of CNV. ICG showed changes in only 6 of the 8 eyes. Hemorrhages were visible on FP in only 4 of the 8 eyes.

Conclusions: : Retinal edema identified by OCT is a reliable indicator of development of CNV and conversion to wet AMD.

Keywords: retina • neovascularization • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)