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J. Nair Sahni, P. Stanga, D. Wong, S. Taylor, S.P. Harding; Correlation of Stratus Optical Coherence Tomography (OCT3) with Clinical and Fluorescein Angiography (FA) Findings in Re-treatment of Subfoveal Choroidal Neovascular Membranes (CNV) with Photodynamic Therapy (PDT) . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4867.
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Purpose: To correlate Stratus Optical Coherence Tomography (OCT3) in subfoveal choroidal neovascular membranes (CNV) treated with Photodynamic Therapy (PDT) with clinical and Fluorescein Angiography (FA) findings. Materials and Methods: Forty consecutive eyes which had already undergone PDT with Verteporfin® were assessed. The CNV was secondary to age-related macular degeneration (AMD) in 33 (82.5%) patients, myopia in 5 (12.5%) and angioid streaks in 2 (5%). Twenty eyes (50%) had 1 previous PDT session, while 5 (12.5%) had 2, 9 (22.5%) had 3, 2 (5%) had 4, 3 (7.5%) had 5 and 1 (2.5%) had 7 previous PDT sessions. All patients underwent slit-lamp biomicroscopy, OCT3 and FA. Presence or absence of cystoid macular edema (CME) and subretinal fluid (SRF) on slit lamp biomicroscopy was documented. Single horizontal line and fast macular OCT3 scans going through the center of the macula were analyzed to determine the presence of a foveal pit. Foveal thickness (FT), intra retinal fluid (oct-IRF), sub retinal fluid (oct-SRF) and vitreo-retinal hyaloidal attachment (VRHA) were also recorded on OCT3. Results: OCT3 scans through the center of the macula were not possible to record in 9/40 (22.5%) patients. There was a statistically significant correlation between FT and the number of PDT sessions (p=0.05), leakage on FA and the presence of either oct-IRF or oct-SRF (p=0.01) and oct-IRF and CME (p=0.05). There was no statistically significant correlation between oct-SRF and SRF detected on biomicroscopy and there was none between oct-IRF and oct-SRF. A VRHA was observed in 8/36 (22%). Seven of 33 patients (21%) patients with AMD showed a VRHA. None of the 5 patients with myopia showed a VRHA. There was no correlation between oct-IRF and VRHA. Conclusions: Foveal thickness decreased as the number of PDT sessions increased. OCT3 detected IRF in patients in whom CME was clinically non-detectable in more than 50% of all instances. IRF and SRF can occur independently of each other. In patients previously treated with PDT we found that OCT3 appears to be more sensitive than slit-lamp biomicroscopy in the detection of CME and may provide additional information for deciding PDT re-treatments.
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