Anomalous vitreoretinal adhesions in patients with exudative age-related macular degeneration: an OCT study

To analyze the relationship between the retina and the vitreous in patients with exudative age-related macular degeneration (ARMD).

Consecutive patients with exudative ARMD, proven by fluorescein angiography, were recruited. Fundus biomicroscopic examination, color and re d - f ree fundus photographs, and serial scans of the macular region using optical coherence tomography (OCT3, Carl Zeiss) were performed before and after photodynamic therapy (PDT) with verteporfin (Visudyne, Novartis Ophthalmics). Vitreoretinal relationships have been described and compared with fundus photographs and data of fundus biomicroscopy examination.

Sixty-six eyes of 52 consecutive patients (33 women, 19 men; mean age 75 years, range 64 to 89 years) with exudative ARMD were studied. Analysis of serial OCT scans showed that 13 eyes (20%) did not present any visible vitreous structures. Two eyes (3%) had the appearance of a complete posterior vitreous detachment (PVD). Fifty-one eyes (77%) exhibited some abnormalities of the vitre o retinal interface including 12 eyes with epiretinal membrane and retinal thickening and distortion. Among the 39 eyes examined before and after PDT with Visudyne, only 3 eyes developed a partial vitreous detachment and 1 eye progressed to a complete PVD.

Eyes with exudative ARMD exhibit a high prevalence of abnormalities of the vitreoretinal interface similar to that observed in many chronic inflammatory diseases. PDT with verteporfin does not modify the observed vitre o retinal adhesions.