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OCT imaging supplants fluorescein angiography for interpreting leakage in wet AMD follow-up
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LAS VEGAS — Even though fluorescein angiography plays an important role in making a baseline assessment of newly diagnosed neovascular age-related macular degeneration, its role in follow-up is supplanted by optical coherence tomography imaging, a speaker said here.
“From a practical standpoint, it’s very hard to interpret leakage [using fluorescein angiography] once you initiate anti-VEGF therapy,” Daniel F. Martin, MD, said at the Optical Coherence Tomography and Imaging Panel Experts Review.
Daniel F. Martin
Rather, OCT is the mainstay of initial evaluation and follow-up of patients with neovascular AMD, he said.
“The primary thing that we’re looking at is fluid,” Martin said. Among the intraretinal, subretinal and subretinal pigment epithelium spaces, the intraretinal space is the location in which fluid affects vision the most, he said.
“Surprisingly, subretinal fluid had almost no impact,” Martin said of not-yet-published data derived from the Comparison of Age-Related Macular Degeneration Treatment Trials.
The most important use of OCT in patients with neovascular AMD is to monitor treatment, he said, considering that 94% of patients in the U.S. are treated with less than monthly dosing, with practitioners choosing either as-needed or treat-and-extend algorithms that prolong the interval between treatments.
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Disclosure: Martin has no relevant financial disclosures.