Photoreceptor status after antivascular endothelial growth factor therapy in exudative age-related macular degeneration.

AIMS: To evaluate the photoreceptor layer status after antivascular endothelial growth factor (VEGF) therapy in choroidal neovascularisation (CNV) secondary to age-related macular degeneration (AMD) using spectral-domain optical coherence tomography (SD-OCT). DESIGN: Prospective, consecutive case series. METHODS: Twenty-three eyes of 22 patients with CNV secondary to AMD with foveal thickness less than 250 microm after treatment with anti-VEGF therapy and no obvious leakage on time domain OCT, and eight healthy subjects as controls, were imaged with at least one of four different SD-OCT devices. The inner and outer segment (IS/OS) photoreceptor layers were graded, and correlated with various characteristics including visual acuity. RESULTS: The IS/OS layer was detected in eight eyes (35%) of patients with AMD and all eyes (100%) of the healthy control subjects (p = 0.002). Eyes in patients with AMD with preserved IS/OS had a significantly better BCVA and mean change in BCVA, and were more likely not to have had previous laser treatment compared with eyes with absent IS/OS. CONCLUSIONS: SD-OCT is a useful tool to visualise IS/OS status. IS/OS is often absent in patients who have received treatment with anti-VEGF therapy for CNV due to AMD. The IS/OS status after anti-VEFG therapy correlates with BCVA and mean change in vision.

Abnormal fundus autofluorescence patterns in myopic choroidal neovascularisation.

BACKGROUND/AIMS: To investigate fundus autofluorescence (FAF) findings in eyes with myopic choroidal neovascularisation (CNV). METHODS: Observational case series. Twenty-seven consecutive eyes with CNV for at least 1 year were included. FAF patterns, time after the onset of CNV seen on FAF and FAF changes were evaluated. RESULTS: The following patterns were observed: pattern I (n = 2), relative hypoautofluorescence around the CNV surrounded by hyperautofluorescence a mean of 17 months after CNV onset; pattern II (n = 11), small lobular or multilobular well-defined FAF defects within a relatively hypoautofluorescent region surrounded by hyperautofluorescence a mean of 35 months after onset; pattern III (n = 4), large lobular or multilobular well-defined FAF defects surrounded by hyperautofluorescence a mean of 59 months after onset; and pattern IV (n = 10), large lobular or crescent-shaped well-defined FAF defects a mean of 107 months after onset. Well-defined FAF defects corresponded to chorioretinal atrophy on colour fundus photographs. During the follow-up period, two eyes with pattern I evolved into pattern II. Lobular or multilobular well-defined FAF defects enlarged in 11 eyes (pattern II, nine eyes; pattern III, two eyes). CONCLUSION: Autofluorescent changes progress over time through pattern grading. A pattern classification might be helpful to predict chorioretinal atrophy changes around myopic CNV.