Abstract
Abstract: :
Purpose: Different morphological subtypes of exudative age–related macular degeneration (AMD) were classified by fluorescein (FA) and indocyanine–green (ICG) angiography. These findings were correlated with optical coherence tomography (OCT) to differentiate the specific morphology in exudative AMD. Methods: A total of 60 patients with classic choroidal neovascularisation (CNV), occult CNV, serous pigment epithelium detachment (PED) with or without associated occult CNV and retinal angiomatous proliferation (RAP) were included. In all patients morphology was assessed by FA and ICG angiography (Heidelberg Retina Angiograph) and OCT (Humphrey System). Results: Classic CNVs were characterized by an increased reflectivity and thickening of the retinal pigment epithelium (RPE) band in the subretinal and choroidal direction with well defined borders and fluid accumulation in the subretinal space consistent with a distinct extension of the CNV in the subretinal and sub–RPE space. In contrast, occult CNVs showed a less confined increased reflectivity mostly underneath the RPE. Occult CNVs with a serous PED showed an increased reflectivity in the sub–RPE space on the border (CNV) with a focal detachment of the RPE band over an optically clear space. PED associated with RAP showed an increased reflectivity of the RPE band on top of the PED. Small PEDs without occult CNV were characterized by increased reflectivity in the sub–RPE space but normal RPE band. Conclusions: The OCT characteristics are consistent with the histopathological concepts of the different exsudative AMD subtypes. Morphology assessed in FA and ICG angiography correlates with the OCT findings as an efficient in vivo tool in patients with exudative AMD.
Keywords: age–related macular degeneration • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • clinical (human) or epidemiologic studies: systems/equipment/techniques