OCT versus Fluorescein Angiography for the Assessment of ARMD Juxtafoveal Visible Choroidal Newvessels Treated by Krypton Laser and Risk Factors for Recurrences.

Abstract

Abstract: : Purpose: To compare OCT and Fluorescein Angiography for the assessment of ARMD juxtafoveal visible choroidal newvessels (VCNV) treated by krypton laser. To identify risk factors for long term recurrences. Methods: Prospective 1 year study of ETDRS visual acuity, FA and OCT before krypton laser treatement and at 2 weeks, 3, 6 and 12 months or more. Results: 16 of 19 eyes were followed more than 1 year. Recurrences were observed after 7.7 ± 3.8 months in 8 eyes, including visible CNV (n=3), occult CNV (n=3) and mixed CNV (n=2). As compared to FA, OCT showed a larger diameter (p=0.009) and foveolar extension (p=0.0001) of preoperative VCNV. This difference was highly significant for eyes in which a recurrence was observed, both for diameter (p=0.0008) and for foveolar extension (p=0.0006) but was not significant for eyes that remained stable after treatment. These recurrences were treated by PDT in 6 eyes, resulting in stabilization of VA in 4 eyes. Conclusions: The hyperreflective signal of VCNV observed on OCT, which appears to extend further than the vascular membrane measured with FA may represent an unidentified histopathological component of CNV (either a fibrous reaction preceding vascularization, or non circulating / occult vessel), and may be indicative of a higher risk of recurrence after laser treatment.

Keywords: laser • retina • retinal neovascularization