Division of Ophthalmology, Northshore University HealthSystem, Evanston, Illinois, USA.
Retina. 2012 Jun;32(6):1045-56. doi: 10.1097/IAE.0b03e31823fb82b.
Optical coherence tomography (OCT) provides microscopic retinal images. Optical coherence tomography is noninvasive, using light waves to produce detailed retinal images. Here, we investigate the ability of OCT to detect early choroidal neovascularization in age-related macular degeneration.
Seventy-nine patients, diagnosed with nonexudative macular degeneration in one eye and exudative macular degeneration in the other were enrolled in this prospective, observational, nonrandomized study. Participants underwent examination (visual acuity, intraocular pressure, biomicroscopy, and ophthalmoscopy) followed by OCT in the study eye (nonexudative macular degeneration eye) every 3 months for 2 years. If examination did not show choroidal neovascularization, but OCT images raised suspicion, patients were reexamined in 4 weeks to 6 weeks and/or fluorescein angiography was performed. Visual acuity, OCT anomaly detected, and time between OCT and fluorescein angiography detection were examined.
Fifteen (19%) patients developed exudative macular degeneration, as confirmed by fluorescein angiography, in the study eye. Four additional patients showed potential exudative macular degeneration on OCT only. Of the 15 patients who developed exudative macular degeneration, 13 had disease progression identified on OCT before examination and/or fluorescein angiography showed changes. Subretinal pigment epithelium fluid was the most common OCT anomaly, with development of sub-/intraretinal fluid also visible.
Optical coherence tomography could be a powerful screening tool for patients with age-related macular degeneration at high risk for developing choroidal neovascularization.
光学相干断层扫描（OCT）提供微观视网膜图像。OCT 是非侵入性的，利用光波生成详细的视网膜图像。在这里，我们研究了 OCT 检测与年龄相关的黄斑变性中早期脉络膜新生血管的能力。
79 名患者，一只眼诊断为非渗出性黄斑变性，另一只眼诊断为渗出性黄斑变性，纳入本前瞻性、观察性、非随机研究。参与者接受检查（视力、眼压、生物显微镜检查和眼底检查），然后在研究眼（非渗出性黄斑变性眼）每 3 个月进行一次 OCT 检查，共 2 年。如果检查未显示脉络膜新生血管，但 OCT 图像提示可疑，患者在 4 周至 6 周内重新检查和/或进行荧光素血管造影。检查视力、OCT 异常检出情况以及 OCT 与荧光素血管造影检出之间的时间。
15 名（19%）患者在研究眼中通过荧光素血管造影证实出现渗出性黄斑变性。另外 4 名患者仅在 OCT 上显示出潜在的渗出性黄斑变性。在 15 名发生渗出性黄斑变性的患者中，13 名在 OCT 检查和/或荧光素血管造影显示变化之前已发现疾病进展。视网膜色素上皮下液是最常见的 OCT 异常，也可见视网膜下/内液的发展。
OCT 可以成为发生脉络膜新生血管风险较高的年龄相关性黄斑变性患者的有力筛查工具。
