Non-exudative OCT findings in neovascular AMD.

Area of Science:

• Ophthalmology
• Medical Imaging
• Retinal Diseases

Background:

• Neovascular age-related macular degeneration (AMD) is a leading cause of vision loss.
• Accurate interpretation of optical coherence tomography (OCT) is crucial for managing AMD.
• Distinguishing true exudation from mimickers is essential for appropriate treatment.

Purpose of the Study:

• To review key OCT biomarkers in neovascular AMD that do not represent active exudation.
• To identify signs that may mimic exudation but do not require treatment.
• To highlight OCT findings indicative of impending exudation and discuss subretinal material origins.

Main Methods:

• Narrative review of existing literature on OCT findings in neovascular AMD.
• Analysis of OCT features that can be mistaken for exudation.
• Categorization of biomarkers based on their implication for treatment and monitoring.

Main Results:

• Identified OCT signs mimicking exudation include outer retinal tubulations, pseudocysts, lipid globules, and hyporeflective wedges.
• Hyperreflective foci and shallow RPE elevations may signal impending exudation.
• Reviewed origins of subretinal hyperreflective material and signs of degeneration like atrophy and thinning.

Conclusions:

• OCT interpretation in neovascular AMD requires careful differentiation of exudative and non-exudative signs.
• Recognizing pseud-exudative OCT findings can prevent unnecessary treatments.
• Monitoring specific biomarkers is vital for timely intervention in AMD management.