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D. D. Esmaili, S. R. Sadda, A. C. Walsh; Quantitative Optical Coherence Tomography Analysis of Choroidal Neovascular Membranes Following Photodynamic Therapy. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2608.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the utility of a software program (OCTOR) that quantifies features of choroidal neovascular (CNV) membranes from optical coherence tomography (OCT) images in patients undergoing photodynamic therapy (PDT).
Medical records for all patients in our clinic with CNV treated with PDT during an 18 month period were retrospectively reviewed. To be included in this study, patients must have had StratusOCT scans at the time of their initial evaluation for treatment and on at least one follow-up visit between 8 and 14 weeks. These OCT scans were graded manually using OCTOR software, which allows for manual tracing of retinal layers as well as delineation of features of CNV including subretinal membranes, sub retinal fluid (SRF), and RPE detachments (PED). The data used for analysis were OCTOR-generated measurements of thickness (in microns) and volume (in milliliters) for retinal tissue, distance from the RPE to the internal limiting membrane (ILM), distance from the choriocapillaris to the ILM, total subretinal distance, and distance from the choriocapillaris to the RPE.
12 eyes of 12 patients who underwent 15 treatments with PDT were evaluated. The average length of time between initial and follow-up treatments was 12.4 weeks. The mean decrease in the total thickness of the neurosensory retina after PDT was 25.9 microns (5.6%). The mean decrease in distance from RPE to ILM, including CNV membranes, SRF and total retinal thickness, was 62.3 microns (10.9%). The height of the subretinal space decreased by an average of 45.8 microns, with two cases of complete SRF resolution. The distance between the choriocapillaris and the RPE decreased by an average of 59.5 microns (25.7%), with one case in which a PED completely resolved.
OCT sub-analysis may be an effective method of monitoring clinically-relevant changes in eyes with CNV after PDT. From this analysis, PDT appears to be effective in reducing the size of both Type 1 and Type 2 CNV membranes. This analysis may also be useful in evaluating the efficacy of anti-VEGF therapy.
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