Abstract
Abstract: :
Purpose: To assess the contribution of optical coherence tomography (OCT) in the management of subfoveal choroidal neovascularization (CNV) related to pathologic myopia and treated by photodynamic therapy (PDT) with verteporfin. Methods: In a prospective study, OCT was performed in eyes with subfoveal CNV related to pathologic myopia identified on fluorescein angiography (FA) and treated by PDT with verteporfin. OCT findings were independently analyzed by two retina specialists based on the following criteria: presence of CNV (defined as a highly or moderately reflective mass protruding from or thickening the retinal pigment epithelium), location of CNV underneath the foveal depression, presence of serous retinal detachment (SRD) defined as an optically clear space between the elevated neurosensory retina and the retinal pigment epithelium on any of the OCT images obtained at the 0°, 30°, 60°, 90°, 120° and 150° planes. The presence of SRD on OCT was considered as requiring a new PDT session. Subsequently, FA was independently analyzed by the same retina specialists in a masked fashion in order to assess the persistence of leakage required for re-treatment. Results: Up to December 1st, 2001, results were available for a consecutive series of 40 patients. OCT findings were not gradable in 4 patients (10%). Extra or juxtafoveal location of CNV was identified by OCT in two eyes, in which CNV were classified as subfoveal based on FA. Intra-observer agreement between FA and OCT as well as inter-observer agreement based on OCT for the decision of re-treatment with PDT at 71 examinations of the remaining 36 patients were very high (respectively 90 and 86%, mean kappa coefficient 0.81 and 0.75). The study is still ongoing. Conclusion: These findings suggest that OCT may provide additional help for the management of CNV in pathologic myopia, for the decision-making of treatment and in particular re-treatment by PDT with verteporfin.
Keywords: 346 choroid: neovascularization • 481 myopia • 516 photodynamic therapy