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AbstractDO.10.14 Spectral domain-optical coherence tomography in patients with pigment epithelial detachments in age-related macular degeneration Hamelmann V., Helb H.-M., Charbel Issa P., Holz F. G., Eter N.
Universitäts-Augenklinik Bonn Objective: To evaluate microstructural alterations in retinal pigment epithelial detachments (PED) secondary to age-related macular degeneration (AMD) by simultaneous confocal scanning laser ophthalmoscopy (cSLO) and spectral domain-optical coherence tomography (SD-OCT).
Methods: 24 eyes of 22 patients with PEDs were examined by simultaneous cSLO and SD-OCT (Spectralis HRA-OCT, Heidelberg Engineering, Heidelberg, Germany). Morphological variations in the various retinal layers were evaluated.
Results: Due to the high resolution a differentiation between the RPE band and the choriocapillaris could be determined in 22 cases, where a thin reflective line in continuation with the curvature of the posterior globe was present representing the anterior border of the choriocapillaries and/or Bruchs membrane. The photoreceptor layer was affected in all patients showing either a reduced thickness or a disturbed internal structure. Sub-neurosensory fluid typically ocurred around the borders of the PED. Intraretinal fluid could be found in various neurosensory layers and to a variable extend with a preference for the outer retinal layers on top of the highest PED elevation. In 17 patients hyperreflective structures could be detected mainly in the outer neurosensory layers possibly representing exudates. In contrast to former time-domain OCT imaging SD-OCT displayed amorphous structures underneath the PED in the majority of cases (21 of 24 cases). Furthermore, in 4 eyes hyperreflective linear structures were visible underneath the PED.
Conclusions: Combined cSLO and SD-OCT imaging with its high resolution provides in vivo details of different morphologies in PED due to AMD. It might prove a useful tool to elucidate the pathogenesis and natural history of this particular AMD manifestation with regard to different subtypes of the disease. Furthermore, differential therapeutic effects of anti-VEGF therapy on various retinal/subretinal layers can be evaluated in more detail, which may also add to the parameters used as retreatment criteria.
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