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R.S. Ramchandran, S. Stinnett, K. Winter, C. Toth; Presurgical OCT Lesion Analysis Predicts Visual Outcomes for Patients Undergoing MT360 for Subfoveal CNV . Invest. Ophthalmol. Vis. Sci. 2005;46(13):214.
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Purpose: To determine whether in vivo lesion morphology, as imaged by presurgical OCT, can predict visual outcomes in AMD patients undergoing 360 degree retinectomy (MT360). Methods: Pre–operative OCTs and pre– and post–operative visual acuity were obtained prospectively from 73 eyes of patients with vision loss from subfoveal neovascular AMD. OCT analysis involved measuring retinal and subretinal lesion thickness and determining lesion characteristics. These data were analyzed to determine relationships between OCT characteristics and visual outcomes for the entire group and for a poor pre–operative vision subgroup (group 2). Results: Very few preoperative OCT factors predicted any one–year postoperative outcomes. The significant correlations were: a) Subretinal fluid thickness with reading speed (p<0.0072) b) The sum of retina and lesion thickness with reading speed (p<0.011) c) presence of vitreomacular attachment with reading speed (p<0.0054), d) For group 2, lesion thickness and near acuity (p<0.024). The relation between lesion thickness and distance acuity in group 2 trended towards significance. In a secondary analysis, the sum of retina thickness plus subretinal fluid correlated with both near acuity (p<0.029) and reading speed (p<0.012). The remaining OCT factors did not predict visual outcomes. Of separate interest, retinal thickness correlated with preoperative near acuity and reading speed while subretinal fluid did not. Conclusions: Although the presence of subretinal fluid might be a marker of lesion activity, it did not correlate with preoperative acuity. However, increasing subretinal fluid beneath the fovea correlated with better outcomes after MT360 surgery. This suggests that presence of subretinal fluid might prevent foveal photoreceptor injury created when the retina is separtated from the underlying RPE during translocation.
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