Spectral-Domain Optical Coherence Tomography Analysis of Fibrotic Lesions in Neovascular Age-Related Macular Degeneration

Autor: Anne Sikorav, Giuseppe Querques, Avi Ohayon, Oudy Semoun, Roxane Bunod, Manar Addou-Regnard, Rocio Blanco-Garavito, Alexandra Miere, Eric H Souied, Camille Jung
Rok vydání: 2020
Předmět:
Male
Vascular Endothelial Growth Factor A
medicine.medical_specialty
Visual acuity
genetic structures
Visual Acuity
Angiogenesis Inhibitors
Retinal Pigment Epithelium
Multimodal Imaging
Retina
Lesion
03 medical and health sciences
0302 clinical medicine
Optical coherence tomography
Fibrosis
Age related
Ophthalmology
medicine
Humans
Fluorescein Angiography
Aged
Retrospective Studies
030304 developmental biology
Aged
80 and over
0303 health sciences
Retinal pigment epithelium
medicine.diagnostic_test
business.industry
Macular degeneration
medicine.disease
Fluorescein angiography
Choroidal Neovascularization
eye diseases
Cross-Sectional Studies
medicine.anatomical_structure
Intravitreal Injections
Wet Macular Degeneration
030221 ophthalmology & optometry
Female
sense organs
medicine.symptom
business
Tomography
Optical Coherence
Zdroj: American Journal of Ophthalmology. 214:151-171
ISSN: 0002-9394
Popis: Purpose To describe the spectral-domain optical coherence tomography (OCT) features of fibrotic lesions associated with neovascular age-related macular degeneration (nAMD) and to outline the progression pathways from initial macular choroidal neovascular lesions (CNVs) to fibrosis. Methods Patients with nAMD were retrospectively included when macular subretinal fibrosis was present. Fibrosis was categorized using spectral-domain OCT with respect to retinal pigment epithelium (RPE) in 836 spectral-domain OCT slices from 44 eyes of 39 patients. In addition, in 47 distinct eyes, 4181 spectral-domain OCT slices were retrospectively reviewed to longitudinally assess progression from the initial lesion to the final fibrosis. Results Cross-sectional analysis classified fibrosis on spectral-domain OCT slices, as type A if located underneath the RPE, as type B if located above the RPE, and as type C if the remaining RPE was undistinguishable. The longitudinal analysis series revealed 3 progression pathways from the original CNV: 1) progression to type A, followed by RPE erosion and subretinal hyperreflective material, then type B and type C fibroglial lesion (FGL; 17/47 eyes); 2) progression to type B then type C FGL (17/47 eyes); and 3) persistence of type A with development of a flat, fibroatrophic lesion (13/47 eyes). Subretinal hyperreflective material, macular hemorrhage, or RPE tear occurred in 14 of 47, 13 of 47, and 10 of 47 eyes, respectively. Conclusion This spectral-domain OCT analysis identified various patterns of macular fibrosis in eyes with nAMD. Three pathways of progression to fibrosis were described including the well-established pathway of type 2 CNV progression to FGL and the progression of type 1 fibrovascular CNV to FGL or fibroatrophic lesion.
Databáze: OpenAIRE
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