[Volume determination of pigment epithelium detachment in AMD by laser scanning tomography]

The possibility of using 3D mapping of AMD-related RPE detachments by means of laser scanning tomography was evaluated to correlate the fluorescein and tomographic findings.

Sixty eyes with AMD-related RPE detachments of 55 consecutive patients (19 men, 36 women) between 54 and 87 years of age (mean: 72.2 years) were examined using the Heidelberg Retina Tomograph (HRT). The parameters considered were area, volume, maximal height and 3D configuration of the RPE detachments. The tomographic data were analyzed and correlated with the fluorescein angiographic findings. Follow-up examinations were done at 3 and 6 months later.

The mean +/- SD area of elevation was 10.59 +/- 5.51 mm2 (range, 0.93-19.73), which correlated well with the angiographic measurements. The mean maximal height was 0.42 +/- 0.19 mm (range, 0.11-0.83), mean volume was 2.55 +/- 1.9 mm3 (range, 0.073-6.63). We found a tendency to grow for untreated RPE detachments, depending on the volume at the first measurement. Three RPE detachments of high volume (mean 0.501 +/- 1.3 mm3) resulted in tearing of the RPE. The angiographic findings of localized neovascularizations in the RPE detachment area (39 of 60 eyes) showed a corresponding irregularity of the surface in most of the correlating 3D HRT figures.

Confocal laser scanning tomography allows analysis of 3D configurations and a quantitative measurement of RPE detachments in AMD. Therefore, this diagnostic technique appears to be useful, especially for differentiated follow-up examinations (as in therapy-control studies). Furthermore, the analysis of 3D configurations seems to be useful to estimate the risk of tearing of the RPE and may help to indicate underlying neovascularizations.