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The use of optical coherence tomography, fluorescein angiography and indocyanine green angiography in a screening clinic for wet age related macular degeneration.
  1. Zachariah R Koshy (zkoshy{at}doctors.org.uk),
  2. Konstantinos Chatzinikolas (kchatzinikolas{at}yahoo.com),
  3. Stephen J Talks (james.talks{at}ncl.ac.uk)
  1. Royal Victoria Infirmary, United Kingdom
  2. Royal Victoria Infirmary, United Kingdom
  3. Royal Victoria Infirmary, United Kingdom

    Abstract

    Aims: To assess the utility of OCT in a nurse led, fast track clinic for new AMD referrals and to see how often ICG led to an additional diagnosis to that provided by FFA.

    Method: Retrospective audit of a consecutive series of 134 new patients referred with suspected wet AMD. When visual acuity was ≥6/60 an OCT was performed. If the OCT was consistent with 'wet' AMD the patient underwent simultaneous FFA/ICG. The sensitivity and specificity of this clinic was calculated. The number of additional diagnoses made using ICG was recorded.

    Results: 23/134 (17.16%) patients had OCT only and were not subsequently found to have 'wet' AMD. FFA/ICG was performed in 111 patients, which showed 'wet' AMD in 90/111 (81%). OCT as used in our clinic had a sensitivity of 1 and specificity of 0.65 for detecting wet AMD. ICG provided additional diagnoses in 19 (14.17%) patients. ICG detected a specific vascular abnormality in 58% of the occult cases.

    Conclusions: OCT proved to be an effective screening tool for wet AMD in this clinic with excellent sensitivity and reasonable specificity. ICGA provided an additional diagnosis in a significant number of cases, but did not define a vascular abnormality in all occult cases.

    • indocyanine green angiography
    • optical coherence tomography
    • wet age related macular degeneration

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