Using Optical Coherence Tomography to Monitor Photodynamic Therapy in Age Related Macular Degeneration

Purpose

To evaluate the role of optical coherence tomography (OCT) in determining choroidal neovascularization (CNV) activity before and after photodynamic therapy (PDT) in patients with age-related macular degeneration (ARMD).

Design

Prospective observational case series.

Methods

setting: Institutional study. patient population: Fifty-three patients (62 eyes) with ARMD. observation procedure: Prospective observational case study. main outcome measures: Presence or absence of leakage on fluorescein angiography, presence of intraretinal or sub-retinal fluid on OCT, and macular and choroidal neovascular complex thickness on OCT.

Results

The macular thickness decreased significantly after PDT (P = .001). However, no significant changes in CNV thickness were measured after PDT (P = .567). Once the diagnosis of ARMD was established before treatment, OCT had a sensitivity of 96.77% for detecting CNV activity. After treatment, OCT had a good sensitivity (95.65%) and a moderate specificity (59.01%) in determining CNV activity, which resulted in a diagnostic efficiency (proportion of correct results) of 82.95%.

Conclusions

OCT appears to be useful for indicating CNV activity. Therefore, it may serve as a complementary technique for deciding the need for PDT and re-treatment in patients with ARMD.