Session Title: AMD I
Session Date/Time: Friday 12/09/2014 | 08:00-10:00
Paper Time: 08:16
Venue: Boulevard C
First Author: : C.Schütze AUSTRIA
Co Author(s): : M. Wedl B. Baumann M. Pircher C.K. Hitzenberger U. Schmidt-Erfurth
To identify the biologic response of the retinal pigment epithelium (RPE) to antiangiogenic therapy for neovascular age-related macular degeneration (AMD) using selective RPE imaging by polarization-sensitive optical coherence tomography (PS-OCT).
Medical University of Vienna
Thirty patients (31 eyes) with treatment-naïve neovascular AMD treated with intravitreal Ranibizumab were included in this study. Patients were examined by SD- (spectral domain) and PS-OCT (capable of specifically detecting the RPE and associated changes) prior to anti-VEGF therapy (baseline), 1, 3, 6, 12 and 24 months postoperatively, focusing on RPE characteristics in PS-OCT. Geographic atrophy (GA) dimensions were evaluated using a semi-automated segmentation algorithm in PS-OCT. SD- and PS-OCT results were compared.
Specific RPE changes were evident in PS-OCT during follow-up including RPE loss: RPE porosity, focal RPE-atrophy, GA, RPE-thinning; and RPE migration: accumulations of depolarizing material at the RPE level and ectopic depolarizing material in outer retinal layers. GA dimensions in PS-OCT were detected in 19 patients at month 24 with a mean area of 1.10mm2 (±1.09). PS-OCT unambiguously identified the RPE layer while conventional intensity-based SD-OCT failed to detect RPE changes.
Characteristic and dynamic changes of the RPE layer were shown in patients undergoing antiangiogenic therapy for neovascular AMD using RPE-specific imaging by PS-OCT. RPE loss and RPE migration was identified. RPE atrophy was generally increasing and GA progression was evident following 24 months of follow-up. Increased RPE density was identifiable in certain cases, presumably following RPE migration and/or proliferation. New insights into our understanding of anti-angiogenic strategies are gained using PS-OCT.