Abstract
Abstract: :
Purpose: To evaluate the optical coherence tomographic characteristics of choroidal neovascularization (CNV) in age related macular degeneration (AMD), in idiopathic and inflammatory CNV and the use of this technique in the selection of patients for macular surgery. Methods: In a prospective study 15 patients with neovascular membranes due to AMD and in 4 patients affected by inflammatory or idiopathic CNV were underwent OCT, fluorescein, and indocyanine green (ICG) angiography. Eligibility criteria for surgery were: subfoveal CNV, juxtafoveal CNV with blood masking the foveal edge, juxtafoveal CNV where the centre of the fovea risked being damaged by laser photocoagulation. Another criterion was the OCT imaging of the CNV: only the CNVs that could be identified above the layer of the RPE were eligible for surgery. The neovascular membrane was surgically removed in four age related CNVs, one inflammatory choroidopathies, and two idiopathic CNVs. In those patients where the CNV was removed, the examinations were repeated within 3 months after surgery. Results: In inflammatory and idiopathic CNV, the OCT displayed a neovascularization on the retinal pigment epithelium (RPE). In two cases the CNV was excised with an improvement of visual acuity equal to or greater than two Snellen lines; in a one case, the visual acuity after surgery was unchanged. In the cases of AMD the OCT fell into three different patterns: (A) CNV above the RPE (five cases); (B) focal, irregular thickening of the retinal pigment epithelial band (3 cases); (C) CNV above and below the RPE (7 cases). Four pattern A CNV patients underwent the surgical excision of the neovascularization. In two cases the visual acuity improved by two or more Snellen lines and in one case the visual acuity remained unchanged Conclusions: The authors suggest that the surgical removal of early age related CNV could be performed in those cases where the OCT shows a neovascular membrane on the RPE, as in idiopathic and inflammatory CNVs.
Keywords: 308 age-related macular degeneration • 346 choroid: neovascularization • 356 clinical (human) or epidemiologic studies: systems/equipment/techniques