%0 Journal Article
%T Is Spectral-Domain Optical Coherence Tomography Essential for Flexible Treatment Regimens with Ranibizumab for Neovascular Age-Related Macular Degeneration?
%A Abdullah Ozkaya
%A Zeynep Alkin
%A Hande Mefkure Ozkaya
%A Alper Agca
%A Engin Bilge Ozgurhan
%A Yalcin Karakucuk
%A Ahmet Taylan Yazici
%A Ahmet Demirok
%J Journal of Ophthalmology
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/786107
%X Purpose. To evaluate the ability of spectral-domain optical coherence tomography to detect subtle amounts of retinal fluid when the choroidal neovascularization is detected as inactive via time-domain optical coherence tomography and clinical examination in neovascular age-related macular degeneration (nAMD) patients. Methods. Forty-nine eyes of 49 patients with nAMD after ranibizumab treatment were included in this cross-sectional, prospective study. All patients were imaged with TD-OCT and SD-OCT at the same visit one month after a ranibizumab injection. The presence of subretinal, intraretinal, and subretinal pigment epithelium fluid (subRPE) in SD-OCT was evaluated; also mean central retinal thickness (CRT) and the rate of vitreoretinal surface disorders detected via the two devices were evaluated. Results. The mean CRT via TD-OCT and SD-OCT was and microns. Sixteen patients (32.6%) showed any kind of retinal fluid via SD-OCT. In detail, 8 patients (16.3%) showed subretinal fluid, 10 patients (20.4%) showed intraretinal fluid, and 3 patients (6.1%) showed SubRPE fluid. The ability of detecting vitreoretinal surface disorders was comparable between the two devices, except vitreomacular traction. Conclusion. SD-OCT is essential for the nAMD patients who are on an as-needed treatment regimen with ranibizumab. Only TD-OCT and clinical examination may cause insufficient treatment in this group of patients. 1. Introduction Neovascular age-related macular degeneration (nAMD) is the leading cause of visual loss among the elderly population in developed countries [1, 2]. Before the introduction of intravitreal antivascular endothelial growth factor therapy for nAMD, only prevention for visual loss might have been achieved in a limited number of patients with different treatment options like laser photocoagulation and photodynamic therapy [3¨C7]. The introduction of bevacizumab (full length antibody against VEGF-A) and ranibizumab (Fab part of antibody against VEGF-A) has led the vast majority of the patients to prevent the baseline visual acuity [8¨C16]. The pivotal multicenter studies with ranibizumab, like MARINA, ANCHOR, PRONTO, EXCITE, and CATT, showed that ranibizumab is effective to prevent baseline visual acuity in up to 95% of the patients and is effective to make an improvement in visual acuity in up to 40% of the patients [9¨C13]. Monthly ranibizumab treatment for nAMD was found to be effective in MARINA and ANCHOR studies; however, an attempt then aroused to decrease the injection numbers. Therefore, studies like PRONTO and FUSION were designed to
%U http://www.hindawi.com/journals/joph/2013/786107/