The new Optical Coherence Tomography Angiography (OCT-A) stands out in the follow-up of patients with exudative AMD
OCT-A is a new non-invasive technique that brings together the advantages of optical coherence tomography (OCT) and conventional angiography. It has the advantage of not requiring the application of intravenous contrast. It was one of the developments that generated the most interest at the EURETINA 2017 Congress, celebrated in Barcelona in early September.
OCT-A allows us to obtain high-resolution images of the blood vessels in the retina, the choriocapillaris and the choroid. In a few seconds, it displays the vascular network in a three-dimensional image and makes it possible to analyse the different layers.
Many ophthalmic diseases originate in the vessels of the retina and the choroid. Although fluorescein angiography continues to be the gold standard for detecting the presence of exudation, OCT-A is particularly useful in the diagnosis and follow-up of different diseases, such as choroidal neovascular membranes, diabetic retinopathy, macular oedema, central serous chorioretinopathy, and arterial and venous occlusions.
Dr Lumbroso's research team (Rome) presented the results of a study on the follow-up of patients in treatment for exudative AMD. Using OCT-A, it was possible to see the response to anti-VEGF intravitreal treatment after 24 hours, and they observed that the maximum effect occurred at 12 days. In the 20-50 days following treatment, the reactivation of the neovascular membrane or the generation of new neovessels was observed, before the accumulation of fluid and decrease in visual acuity.
Therefore, analysing these patients using OCT-A was very useful for establishing optimum timing in intravitreal treatment.
Dr Ferraro, Institut de la Màcula's Ophthalmologist, specialising in the macula and vitreoretinal diseases.
Photo: OCT-A in patients with age-related macular degeneration, which allows for visualization of the neovascular membrane.
*Lumbroso B, Rispoli M, Savastano MC, Jia Y, Tan O, Huang D. Optical Coherence Tomography Angiography Study of Choroidal Neovascularization Early Response after Treatment.