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Christoph Roman Clemens, Peter Heiduschka, Florian Alten, Nicole Eter; Assessing the function-morphology ratio of choroidal neovascularization and pigment epithelium detachment in age-related macular degeneration using OCT-angiography. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4948.
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© ARVO (1962-2015); The Authors (2016-present)
The architecture and the vascular characteristics of a vascularized pigment epithelium detachment (vPED) in age-related macular degeneration (AMD) are the most relevant factors regarding the risk of retinal pigment epithelium (RPE) tear development. Based on fluorescence angiographic (FA) data, previous studies described the morphologic proportions of choroidal neovascularization (CNV) and PED lesion as particularly relevant for the likelihood of tear development. The aim of our study was to extend the morphologic CNV/PED ratio by incorporating functional optical coherence tomography angiography (OCT-A) imaging in the vPED analysis.
Multimodal imaging was performed in twelve eyes of ten patients (71.3 ± 7.6 years) with a vPED lesion due to AMD including structural OCT, FA, indocyanin green angiography and OCT-A. Based on OCT-A imaging, the perfusion index (PFI) in the CNV area as well as the morphologic CNV/PED ratio (mR) were assessed resulting in a functional CNV/PED ratio (fR) = PFI/mR.
Mean PED lesion size was 6.47 mm2, mean CNV lesion size was 4.03 mm2. The mean mR was 0.65 ± 0.26 and functional measurements showed a PFI of 73.8 ± 17.1. Both values were negatively correlated (p=0.04). The mean fR was 134 ± 61. Lesions with a mR < 0.5 showed a mean fR of 174.8 ± 69.6 and lesions with a mR > 0.5 showed a mean fR of 106.8 ± 33.6. mR and fR were negatively correlated (p=0.007).
Adding the functional component to the morphologic CNV/PED ratio appears promising with regards to a more sensitive predictability of impending RPE tear development particularly in high-risk vPED patients.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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