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Fluorescein angiography 'critically important' in monitoring AMD, surgeon says
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NUSA DUA, Indonesia — Though many retinal specialists have begun using only optical coherence tomography for age-related macular degeneration monitoring, a surgeon said here that fluorescein angiography should not be discounted and should be used in conjunction with OCT.
 Alexander J. Brucker |
"Personally, I think it is critically important that we do fluorescein angiography on a regular basis," Alexander J. Brucker, MD, said during the joint meeting of the Asia-Pacific Academy of Ophthalmology and American Academy of Ophthalmology. "We suggest changing the treatment guidelines for age-related macular degeneration by redefining the role of fluorescein angiography in the following and treatment of age-related macular degeneration."
In the APAO Special Lecture, Dr. Brucker showed a small study of 321 patients in which 2.18% of patients who were shown to be dry on an OCT were shown to be wet on fluorescein angiography.
"In age-related macular degeneration, we the physicians need to understand this is a choroidal disease. As a choroidal disease, it's a dynamic process," he said, explaining that the FA images show the active process of AMD while the OCT images show the result of that disease.
"[OCT] is simply a stagnant photograph of the result of the leakage, not of the pathologic process," he said. "Fluorescein angiography adds to our understanding of the process."
Dr. Brucker showed cases where patients were treated or not treated solely on OCT images and went on to lose vision because underlying disease was ignored. In his practice, Dr. Brucker said they conduct a fluorescein angiography exam every 12 weeks, even in cases of dry OCT images.