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Using optical coherence tomography to monitor photodynamic therapy in age related macular degeneration
Angel Salinas-Alamán1, Alfredo García-Layana, Miguel J Maldonado
1Department of Ophthalmology, University Clinic, University of Navarra, Pamplona, Spain. asalinas@unav.es
Purpose:
To evaluate the role of optical coherence tomography (OCT) in determining choroidal neovascularization (CNV) activity before and after photodynamic therapy (PDT) in patients with age-related macular degeneration (ARMD).
Design:
Prospective observational case series.
Setting:
Institutional study. patient population: Fifty-three patients (62 eyes) with ARMD.
Observation Procedure:
Prospective observational case study.
Main Outcome Measures:
Presence or absence of leakage on fluorescein angiography, presence of intraretinal or sub-retinal fluid on OCT, and macular and choroidal neovascular complex thickness on OCT.
Results:
The macular thickness decreased significantly after PDT (P = .001). However, no significant changes in CNV thickness were measured after PDT (P = .567). Once the diagnosis of ARMD was established before treatment, OCT had a sensitivity of 96.77% for detecting CNV activity. After treatment, OCT had a good sensitivity (95.65%) and a moderate specificity (59.01%) in determining CNV activity, which resulted in a diagnostic efficiency (proportion of correct results) of 82.95%.
Conclusions:
OCT appears to be useful for indicating CNV activity. Therefore, it may serve as a complementary technique for deciding the need for PDT and re-treatment in patients with ARMD.
