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Ultrahigh resolution optical coherence tomography in non-exudative age related macular degeneration
  1. C G Pieroni1,
  2. A J Witkin1,
  3. T H Ko2,
  4. J G Fujimoto2,
  5. A Chan1,
  6. J S Schuman3,
  7. H Ishikawa1,
  8. E Reichel1,
  9. J S Duker1
  1. 1New England Eye Center, Tufts-New England Medical Center, Tufts University, Boston, MA, USA
  2. 2Department of Electrical Engineering and Computer Science and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA
  3. 3UPMC Eye Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
  1. Correspondence to: Elias Reichel MD, New England Eye Center, Tufts-New England Medical Center, Tufts University, 750 Washington Street, Box 450, Boston, MA 02111, USA; ereichel{at}tufts-nemc.org

Abstract

Aim: To describe the appearance of the non-exudative forms of age related macular degeneration (AMD) as imaged by ultrahigh resolution optical coherence tomography (UHR-OCT).

Methods: A UHR-OCT ophthalmic imaging system, which utilises a femtosecond laser light source capable of ∼3 μm axial resolution, was employed to obtain retinal cross sectional images of patients with non-exudative AMD. Observational studies of the resulting retinal images were performed.

Results: 52 eyes of 42 patients with the clinical diagnosis of non-exudative AMD were imaged using the UHR-OCT system. 47 of the 52 (90%) eyes had the clinical diagnosis of drusen and/or retinal pigment epithelial (RPE) changes. In these patients, three patterns of drusen were apparent on UHR-OCT: (1) distinct RPE excrescences, (2) a saw toothed pattern of the RPE, and (3) nodular drusen. On UHR-OCT, three eyes (6%) with a clinical diagnosis of non-exudative AMD had evidence of fluid under the retina or RPE. Two of these three patients had findings suspicious for subclinical choroidal neovascularisation on UHR-OCT.

Conclusion: With the increased resolution of UHR-OCT compared to standard OCT, the involvement of the outer retinal layers are more clearly defined. UHR-OCT may allow for the detection of early exudative changes not visible clinically or by angiography.

  • AMD, age related macular degeneration
  • CNV, choroidal neovascularisation
  • IS, inner segment
  • OCT, optical coherence tomography
  • OS, outer segment
  • RPE, retinal pigment epithelium
  • UHR-OCT, ultrahigh resolution optical coherence tomography,
  • VEGF, vascular endothelial growth factor
  • ultra high resolution optical coherence tomography
  • age related macular degeneration
  • drusen

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