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Ultrahigh resolution optical coherence tomography in non-exudative age related macular degeneration


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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